Poor balance, a persistent problem for millions of Americans, triggers many falls. In young, healthy adults, balance is largely an automatic reflex. However, gradual changes linked to growing older—such as weak or inflexible muscles, slower reflexes, and worsening eyesight—affect the sense of balance. Certain health problems—such as inner ear disorders, neuropathy, and heart rhythm disturbances—may upset balance, too. So can alcohol and many medications. Perhaps it's not surprising that every year, at least one out of three people over age 65 falls. Shaky balance can spur a downward spiral. Often, people begin moving around less during the day, voluntarily cutting back activities. Confidence dips, muscles essential to balance grow weaker still, and unsteadiness rises in response. So does fear of falling—and falls. But there are ways to improve balance. Better Balance, a Special Health Report from Harvard Medical School, shows you how. To create this report, two physicians with expertise in balance and aging joined forces with two master trainers to develop safe, effective balance exercises that can help stop this cycle. With practice, almost anyone can achieve better balance. Strong legs and flexible ankles help prevent falls and allow you to catch yourself if you do trip. What's more, the full blend of recommended activities can help you build better awareness of your body and surroundings, boost your confidence, and tune up your heart and lungs to keep you healthy and independent.