Health Answers

Study finds balance issues are widespread in older people

By Judy Foreman
September 28, 2009

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Q. Does keeping one’s balance get harder with age?

A. It certainly does, according to a study from Johns Hopkins University, and the inner ear problems that trigger balance problems are far more widespread than doctors thought.

In the new study, ear specialist Dr. Yuri Agrawal and her team examined government health data on more than 5,000 Americans ages 40 or older. They found - to their astonishment - that more than one-third (35 percent) had vestibular dysfunction, an inability of the delicate balance system in the inner ear to function properly. Many people did not know they were at increased risk of falls because they had not yet experienced dizziness or suffered serious falls. Complications from falls are a major cause of death and disability in older people.

The study, published in the Archives of Internal Medicine, shows that “balance problems are a big public health problem,’’ said Dr. Steven Rauch, an ear specialist at the Massachusetts Eye and Ear Infirmary. “To realize such a high proportion of the population is heading in that direction is a real eye-opener,’’ he added, noting that good balance is actually a function of three bodily systems: the inner ear, the eye, and the proprioceptor nerves in muscles and joints that let a person know the position of the body at any given time.

There is not much - so far - that doctors can do to treat some underlying causes of vestibular dysfunction, such as damage to delicate hair cells in the inner ear from infections and antibiotics, said Agrawal of Hopkins. But doctors can help patients manage diabetes, a major contributor to damage in nerves and blood vessels in the balance system. And physical therapists can offer vestibular rehabilitation - essentially retraining the balance system to reduce dizziness.

People can reduce the risk of falls by making homes safer - removing scatter rugs, improving lighting in halls, installing handrails - and doing balance exercises such as tai chi that “challenge the very system that’s down,’’ said Agrawal.

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