⚖️ Why Do Elderly Lose Balance or have Balance Problems?

Normal gait and balance seem easy to come by until the effects of advanced age start to kick in. With age comes complications that can adversely affect one’s balance when standing, walking, or carrying out routine tasks. Unsurprisingly, balance problems are some of the common issues with which seniors visit their doctors. Ideally, your body position should remain in balance without any staggering or falling. In this detailed guide, we will look at the main causes of balance problems in older adults and touch on some tips that can alleviate these problems.

Inner Ear Issues

A significant percentage of balance and gait problems can be traced back to inner ear issues [1]. Here is a brief look at some of the common ones.

Earwax

All of our ears have some earwax; some people have more than others depending on a wide range of factors. While the presence of wax in the ears is all very natural, a buildup of the same can lead to balance issues and hearing problems. Older people tend to be at more risk of having wax buildup than young people. Additionally, the wax problems can worsen if one uses cotton swabs the wrong way, leading to compacted wax inside the ear. If you begin to experience balance issues resulting from a buildup of wax, it is advisable to visit your doctor for immediate attention.

Labyrinthitis

Labyrinthitis is an inner-ear condition that causes inflammation on a delicate ear structure known as the labyrinth. This inflammation, in turn, causes hearing and balance problems. Some of the common symptoms associated with Labyrinthitis include hearing loss, tinnitus, dizziness, nausea, and vertigo.

Vestibular neuritis

This condition is also referred to as neuronitis. It is the infection of the inner ear vestibular nerve. The infection causes inflammation on the nerve, affecting your gait and balance. Neuronitis can be caused by bacterial or viral infections and may portray symptoms such as hearing loss and lack of balance. One is advised to visit a qualified medical professional in case of pain, discomfort, or inflammation in the inner ear.

Perilymph Fistula

Perilymph Fistula results from the leakage and movement of fluid from the inner ear into the middle ear. The fluid then results in instability, particularly during activities such as walking and running. The condition can also manifest in other symptoms such as nausea and dizziness. Perilymph Fistula can come from head injuries, physical exertion, ear infections, or abrupt changes in air pressure.

Meniere’s Disease

When it comes to inner ear conditions, Meniere’s disease is among the rare ones. This condition causes a feeling of pressure inside the ear, vertigo, hearing loss, tinnitus, and balance loss. Those with this condition often describe experiencing pressure buildups inside the ear, followed by bodily imbalance episodes and hearing loss.

High or Low Blood Pressure

Optimum blood pressure plays a huge role in maintaining a person’s ideal gait and balance. Seniors with low blood pressure may often feel dizzy and imbalanced, particularly after changing positions (such as seated to a standing position). Low blood pressure [2] in the body often results from low arterial blood pressure. When this happens, your brain receives insufficient blood, leading to light-headedness, dizziness, and possibly, lack of balance.

Other symptoms of low blood pressure include nausea, confusion, irregular heartbeat, and blurred vision.
Unlike high blood pressure, low blood pressure often only requires attention when it begins to show discernible symptoms. However, one can adopt various lifestyle changes to combat the condition. These changes include eating small regular meals, wearing support stockings, and avoiding standing for long periods.

Medications

For most seniors, avoiding drugs can be almost impossible. Age comes with numerous medical conditions, often requiring one to have regular medicines. The problem is that some of these necessary medicines come with imbalance-related side effects. Some drugs have a more pronounced effect than others. For example, medications designed to alter a patient’s blood pressure are known to make patients feel dizzy and imbalanced. Other drugs, such as ototoxic medicines, can affect the inner ear’s workings, resulting in loss of balance. Here is a brief look at some of the medicines [3] that can cause imbalance issues.

  • Sleep drugs such as hypnotics and sedatives
  • Pain drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids
  • Heart medications: These include nitrates, digoxin, anti-arrhythmic drugs, and other vasodilators
  • Diabetes medications: These include glipizide, glyburide, and insulin
  • Blood pressure medications: These include alpha-blockers, beta-blockers, angiotensin-receptor blockers (arbs), ace inhibitors, and centrally acting antihypertensives.
  • Antispasmodic/anticholinergic medications such as those used to treat stomach cramping.
  • Antihistamines
  • Antidepressants: These include serotonin-norepinephrine reuptake inhibitors (SNRIs) and selective serotonin reuptake inhibitors (SSRIs).
  • Anti-anxiety medications such as benzodiazepines

Loss of Muscle Strength

Typically, old age is associated with a continual decline in a person’s muscular strength. The loss of leg muscle strength [4] increases the risks associated with imbalance, falls, and a sedentary lifestyle. Aging often comes with a reduction in muscle mass and strength, a condition known as sarcopenia. This reduced muscle strength increases a person’s frailty, loss of independence, and loss of physical functions. Additionally, this loss of strength affects a person’s gait and balance significantly.
Typically, a person’s movement is guided by opposing muscle groups that must work in coordination for proper motion. With muscle-related imbalance, the working of the aforementioned muscle group becomes uncoordinated. Here is a look at the two common forms of muscle imbalance.

Joint Muscle Imbalance

In this condition, one or more muscles surrounding a joint becomes tighter, looser, stronger, or weaker than normal, resulting in an imbalance that affects joint movement. Ideally, all the muscles surrounding a joint coordinate via opposing forces to keep the joint centered.

Body Muscle Imbalance

Under normal circumstances, the muscles on either side of your body should be symmetrical in terms of strength and size. When a muscle or group of muscles on one side becomes weaker, stronger, smaller, or larger than those on the opposite side, it results in body muscular imbalance.

Vitamin Deficiency

This deficiency can result in vitamin deficiency [5] anemia, a condition in which one’s body does not have sufficient vitamins required to produce adequate red blood cells. The cells are responsible for transporting oxygen from the lungs to other body parts. With vitamin deficiency anemia, insufficient oxygen getting to the brain can lead to balance-related problems. Here is a look at the risk factors associated with this condition.

Lack of Vitamins in the Diet

As a senior, it is super important to have sufficient vitamin-laded meals. These include vegetables, fruits, dairy products, and meat. If your meals do not contain enough vitamins, it is quite possible to get vitamin deficiency anemia.

Overcooking Food

Overcooking foods such as vegetables can deprive them of vitamin content. While it is important to consume well-cooked foods, ensure that you do not overdo the cooking and end up with vitamin-stripped foods.

Intestinal Problems

Intestinal issues may tamper with the absorption of vitamins into the body. Additionally, the presence of unwanted bacteria on your stomach lining could interfere with the absorption of the essential Vitamin B12.

Excessive Alcohol Intake

Alcohol interferes with the intake of Vitamin C and folate into the body. If a senior is experiencing balance-related problems arising from insufficient vitamins, you might want to limit their alcohol intake.

Some Medications

Some prescription drugs can interfere with vitamin B12 absorption significantly. For example, antacids and anti-seizure drugs can block the efficient absorption of folate and other vitamins. It is advisable to consult a qualified professional if you are having a vitamin deficiency problem and are currently on prescription for such drugs.

It is worth noting that vitamins, particularly vitamin B12, are essential for a well-functioning nervous system. When left untreated, a vitamin B12 deficiency can easily cause neurological issues in your body, such as foot problems, persistent tingling on your hands, and loss of correct gait and balance.

Dealing with Imbalance

Due to the numerous causative factors, you or your loved one may develop balance issues. If this happens, there are numerous steps you can take to alleviate the problem.

Seek Medical Attention

The first and most straightforward step to take once you begin to experience a loss of balance is to seek medical attention. More often than not, the imbalance is caused by easily-treatable conditions. However, these conditions can quickly evolve into more serious problems if left untreated.

Invest in a Senior Walker

Walkers are simple devices designed to assist seniors in walking and standing. These products are often made from lightweight metal alloys, making them sturdy and durable. When the loss of balance or muscle strength is more pronounced, a good walker can help the older adult.

Use Transfer Poles

Like adult walkers, transfer poles are designed to help a person stand, sit, and move around. This tool can be immensely useful in enhancing mobility for a person with a loss of balance problem.

Conclusion

The loss of balance can immensely affect a senior’s mobility, independence, and safety. However, some of the issues related to this imbalance can be dealt with using lifestyle changes, medical attention, and mobility aids.

Citations

  1. https://www.hearinglink.org/your-hearing/balance-disorders/common-balance-disorders/
  2. https://www.brainandspine.org.uk/wp-content/uploads/2018/02/BSF_Dizziness-and-balance-A5-booklet.pdf
  3. https://www.health.harvard.edu/staying-healthy/how-medications-can-affect-your-balance
  4. https://journals.sagepub.com/doi/pdf/10.1177/1721727X1301100118
  5. https://www.mayoclinic.org/diseases-conditions/vitamin-deficiency-anemia/symptoms-causes/syc-20355025
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