Aging, Balance, and Dizziness

Balance: One of the leading health concerns for people over 60 is falling. Balance in walking and standing is dependent on many factors. The elderly have a higher risk of contracting many different kinds of diseases that can interfere with balance, including cataracts, glaucoma, diabetic retinopathy, and macular degeneration, which all affect vision; peripheral neuropathy, which affects position sense in the feet and legs; and vestibular-system degeneration.

Balance is also dependent on good muscle strength and joint mobility. A sedentary lifestyle and arthritis or other diseases of bones and muscles can compromise strength and mobility. Yet even healthy people over 65 appear to have more trouble than younger people in maintaining their balance on soft or uneven surfaces when visual cues are not available (e.g., in the dark).

Dizziness in the elderly can be a result of problems with the vestibular, central (brain-related), and vision systems, as well as from neuropathy, psychological causes, and unknown causes. Vestibular disorders, however, are thought to be the most common cause of dizziness in older people, responsible for approximately 50% of the reported dizziness in the elderly.

Until recently, relatively little was known about the consequences of aging for the vestibular system. Anatomical studies have shown that the number of nerve cells in the vestibular system grows smaller with age, beginning at about age 55. The loss becomes more severe as age progresses.

Of all vestibular disorders, benign paroxysmal positional vertigo (BPPV) is one of the most common. See the description of BPPV and treatment for it through vestibular rehabilitation therapy (balance-retraining exercises and maneuvers).

The ability to move about freely is an important factor in the quality of life of both younger and older people. A healthy vestibular system is vitally important to freedom of movement.

From VEDA publication R-3, Balance and Aging.