What Causes Balance Problems in the Elderly?

By Barbara Hales, M.D.
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Elder waiting to cross a zebra crossing supported by a walker.

We achieve balance with a mixture of sensory information from the central nervous system, mobility, and strength. When any of these are compromised, balance can be lost.

Balance problems can occur in the elderly when there is dysfunction with the inner ear, nerves, heart, eyes, joints, muscles and bones, which must all act in unison.  Since these systems may start to deteriorate as we age, balance issues become more common in the elderly.

Symptoms of balance problems include:

  • Blurred vision
  • Confusion/disorientation
  • Dizziness/vertigo
  • Faintness
  • Falling sensation
  • Floating sensation
  • Lightheadedness
  • Unsteadiness/loss of balance

Causes of balance problems in the elderly

Elderly balance deterioration is responsible for an increase in falls each year, so it is key to diagnose and address the problems responsible for loss of balance.

Usual causes of imbalance and falls include:

  • Decline in vision
  • Vestibular system issues (i.e. inner ear problems)
  • Weaker legs and hips from joint problems
  • Poor posture
  • Spinal degeneration
  • Poor response time
  • Low blood pressure
  • Drug interactions or adverse reactions to medications
  • Difficulty raising feet leading to stumbling

Chiropractic Treatment of balance problems in the elderly

Chiropractic treatment is an effective method for seniors to maintain an active, healthy and independent way of life.  The balance and coordination problems that seniors suffer from are often due to degenerative cervical spine changes and prior trauma.  Chiropractors stimulate joint receptors to reinstate coordination.  This improves joint receptor performance, which controls balance.

PT Treatment

Balance exercises are crucial for the elderly.  Physical therapists can evaluate thresholds related to balance and disabilities. When problematic areas are diagnosed, a PT can formulate an individualized exercise program to improve balance, increase flexibility and strengthen muscle groups. 

Balance Exercises

  • Eye tracking

Hold your thumb in front of you and focus on it.  Move it to the right and left, watching with your eyes and leaving your head stead.  Then repeat with your arm outstretched.  

  • Single limb stance

Balance on one leg while holding onto a chair or countertop.  After a few seconds, repeat with your other leg.  Work up to one minute.  When that is mastered, try holding with one hand, then one finger and finally without holding the chair.

  • Heel to toe

Stand with one foot in front of the other. Step forward and alternate each foot in front of the other.

  • Single limb with arm

Stand with feet together.  Hold onto a chair and raise your left arm overhead.  Then lift your left leg off the floor for ten seconds.  Repeat for right side. Inhale through the nose and exhale out the mouth.

  • Balancing wand

Hold a stick, cane, umbrella or broom handle in one hand. Focus at the top and balance it while sitting down.

  • Knee marching

Stand with arms at your sides and feet shoulder width apart.  Lift one knee up and return to floor.  Then lift the other knee.  Do a series of 20 lifts each knee.

  • Stepping

The aim of this exercise is to improve lifting your feet and strengthen your leg muscles.  Space out two soft objects 12 to sixteen inches apart on the floor.  Stand to one side of the objects. Step forward, then to the side around the object.  Repeat with each soft object on the ground. As mastery occurs, one can try figure eights around the objects.

  • Grapevine

Stand with feet together and arms at sides. Take your right foot and cross it over the left leg.  Cross and uncross as you move across the room.  Then step sideways with the other foot.

  • Dynamic walking

This is to train our vestibular system to anticipate head motions, scanning left to right while walking.  Walk slowly, turning your head from left to right and repeat.

 

  • Body circles

Stand with fee shoulder width part and sway in a circle for one minute.

Acupuncture

Acupuncture is a traditional Chinese medicine that encompasses thin needles being inserted into pressure points, stimulating nerves to affect functions of organs and tissues in the body. When the life force or qi is improved, then good physical health is obtained.

Studies have shown that acupuncture has been effective for:

  • Allergies
  • Anxiety
  • Balance
  • Chronic Pain
  • High blood pressure
  • Insomnia
  • Menstrual cramps
  • Migraines  
  • Morning sickness

The most typical reaction is one of happiness and contentment.

Are balance problems in the elderly chronic?

The answer to this is no.  If properly addressed, balance can be improved.

Sources:

Furman JM, et al. Evaluation of the patient with vertigo. https://www.uptodate.com/contents/search.

https://www.nidcd.nih.gov/health/balance-disorders. 

Hyun AH, et al. Hemodynamic orthostatic dizziness/vertigo: Diagnostic criteria. 2019; doi:10.3233/VES-190655.

Branch WT, et al. Approach to the patient with dizziness. https://www.uptodate.com/contents/search. 

Barton JJS. Benign paroxysmal positional vertigo. https://www.uptodate.com/contents/search. 

Moskowitz HS, et al. Meniere disease: Evaluation, diagnosis, and management. https://www.uptodate.com/contents/search. 

Vestibular testing. American Hearing Research Foundation. http://american-hearing.org/disorders/vestibular-testing/#rotatory. 

Furman JM, et al. Treatment of vertigo. https://www.uptodate.com/contents/search. 

Kaufmann, H. Treatment of orthostatic and postprandial hypotension. https://www.uptodate.com/contents/search. 

https://www.cdc.gov/steadi/pdf/STEADI-Brochure-WhatYouCanDo-508.pdf