and fall risk. Cost of falls Falls and fall-related injuries are among the most common but serious medical problems experienced by older adults. Nearly one-third of older people fall each year, half of which fall more than once per year. Over 3 million Americans over the age of 65 visited hospital emergency departments in 2015 due to fall-related injuries, with over 1.6 million being admitted. Because of decreased bone density due to osteoporosis, mobility, and reflexes, falls often result in hip fractures and other fractures, head injuries, and death in older adults. Accidental injuries are the fifth most common cause of death in older adults. 75% of hip fracture patients do not recover completely and show signs of overall health deterioration. Strategies and interventions Motor-cognitive training is increasingly viewed as the gold standard for healthy aging and fall prevention. One approach that has been researched is the introduction of semi-immersive virtual reality simulation during treadmill training. Initially conceptualized by the Tel Aviv Sourasky Medical Center with funding from the Michael J Fox Foundation and the European Commission, V-TIME projects a real-time image of participants' feet onto a large screen at eye-level while the participants are walking on a treadmill. The virtual environment introduces multiple physical and cognitive challenges while the participant is in dynamic motion. This one approach to motor-cognitive training was found to repeatedly reduce falls by 50% after 5 weeks of 15 sessions across multiple clinical trials and multiple indications (idiopathic, Parkinson's, Multiple sclerosis). The biological manifestations of this improvement were identified through functional MRI, which showed changes in brain activity patterns for patients that were exposed to combined motor-cognitive training, as opposed to exclusively physical training. Other preventative measures with positive effects include strength and balance training, home risk assessment, the withdrawal of psychotropic medication, cardiac pacing for those with carotid sinus hypersensitivity, and tai chi. Resistance exercise two or three times a week with ankle weights or elastic bands has been proven in tests to rebuild lost muscle mass and reduce falls in adults of all ages: it was first tested in New Zealand by the Otago Medical School in four controlled trials, in which about 1,000 older adults with an average age 84 participated. Falls among a test group that did the Otago routines three times a week for 12 months was 35% fewer than a control group that did not use the routines. Two