To maintain balance, our brains must rapidly and continuously integrate and then process the sensory information received from three these systems, visual (eyes), vestibular (inner ear and semi-circular canals) and somotosensory (sensation feedback from joints in our neck, spine, knees and ankles) systems.
These provide us with the sensory information about our bodies and the surrounding environment that we need to maintain balance
Unfortunately, in older people these systems don’t always work as well and this can lead to an increased risk of falls in the elderly.
Why do older people seem to find it difficult to balance ?
Poor balance is usually caused by several different health conditions such as underlying neurological conditions, vestibular problems, dizziness caused by high blood pressure, certain types of medication or the incorrect dosage. Also, as we age a sedentary lifestyle can lead to reduced muscle strength and unstable joints that in turn cause balance problems and an increased falls risk.
What causes balance problems in the elderly ?
Loss of balance is often a symptom of another health condition instead of being a stand-alone condition that needs treatment
Very often there are several different health conditions that can affect a person’s balance
- Parkinson’s disease
- Multiple sclerosis
- Decreased blood flow to the brain due to stroke or a chronic condition such as aging.
- Traumatic brain injury.
- Cerebellar diseases
- Acoustic neuromas and other brain tumours
Vertigo (sense of motion or spinning). There are main conditions that can be associated with vertigo such as:
Meniere’s disease: It can cause fluctuating hearing loss and buzzing, ringing or a feeling of fullness in your ear. The cause of Meniere’s disease isn’t fully known.
Benign Paroxysmal Positional Vertigo (BPPV): It is one of the most common causes of vertigo and occurs when calcium crystals in your inner ear which help control your balance are dislodged from their normal positions and move elsewhere in the inner ear.
Vestibular neuronitis: It is an inflammatory disorder of the inner ear which can affect the nerves in the balance part of your inner ear. Symptoms include difficulty walking and nausea and can be persistent and severe.
Superior semicircular canal dehiscence syndrome (SCCD): This is caused by an abnormal thinning or incomplete closure of one of the bony canals in the inner ear. The intracranial pressure caused by coughing or sneezing can trigger balance problems.
Acoustic neuroma: It is a benign tumour (non-cancerous) on the nerve connecting the ear to the brain.
Cochlear hydrops: This affects the balance of the inner ear.
Certain medications or the incorrect use of it and lead to problems in vestibular function. Common prescribed medications are some antibiotics, diuretics, aspirin and quinine.
Dizziness can be caused by any medication but is more common in some of the following –
- sleeping pills
- anti anxiety medication
- anti-psychotic drugs
- alcohol and illegal drugs
High blood pressure
High blood pressure and dizziness are often associated because a person with uncontrolled hypertension may present with dizziness. In fact, dizziness may be the only symptom of hypertension.
Inactivity and sedentary lifestyle
Balance is a skill that requires practice. Regular balance exercises and physical activity may help a person improve their coordination and balance.
What are the signs and symptoms of balance disorders as we get older ?
- Sense of motion or spinning (vertigo)
- Feeling of faintness or lightheadedness (presyncope)
- Loss of balance or unsteadiness
- Reduced strength in muscles and weakness in your joints
- Falling or feeling like you might fall
- Feeling a floating sensation or dizziness
- Vision changes, such as blurriness
How do you know if you have a balance problem ?
If you can answer “yes” to one or more of the following balance related questions, then it may be a good opportunity to talk to your medical practitioner or doctor who can do further tests.
- Does my vision become blurred ?
- Do I feel as though I am falling ?
- Do I feel unsteady when I stand or move around ?
- Do I feel dizzy or if the room is spinning around me ?
- Do I often have to hold on to furniture or objects to correct my balance when walking ?
- Do I feel as though I am moving even when standing still ?
If you think you have a balance problem, schedule an appointment with your doctor.
Your doctor may refer you to an otolaryngologist, a physician with special training in problems of the ear, nose, throat, head, and neck.