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Screenshot_3_11_13_12_24_PMApproximately 12.5 million Americans over the age of 65 have a dizziness or balance problem that significantly interferes with their lives. The ability to maintain one’s balance is controlled by 3 major sensory systems that provide information for the brain to process—the visual, vestibular and somatosensory systems, also known as, the eyes, ears and feet.

The vestibular (ear) system is the first sensory system to develop. It is visible at two months gestation and fully formed by the fifth month of gestation. The semi-circular canals, the saccule and utricle are housed in the inner ear. The semi-circular canals, utricle and saccule provide information on head rotation, position and body direction, and speed of movement to assist the brain’s processing of our orientation in space and to coordinate associated eye movements. As we age, beginning at approximately 55 years old, the number of vestibular nerve cells and blood flow to the inner ear decreases. This may manifest as slow, gradual changes in the quality of balance. One may start to notice imbalance with standing or walking in various conditions, such as, dim or dark lighting, across thick carpet, grass or sand or on uneven surfaces like gravel, cobblestone, ramps and stairs.

What can you do to combat these age-associated changes in the inner ear?

  • Have hearing and vision check-ups regularly. If hearing and vision are impaired, important cues that help maintain balance can be lost.
  • Hearing tests can be used to detect inner ear disorders that affect both balance and hearing.
  • Keep your contact lenses or eye glasses prescription current. An article from the Journal of Physical Therapy stated that a visual acuity of 20/40 can cause imbalance. For those who have presbyopia (where you experience blurred near vision), you may want to consider having a specific pair of glasses for reading and a separate pair for intermediate/far distances to minimize conflicts in depth perception (that affect balance) that can occur with bifocal or progressive lenses.
  • Take care of your feet. Remember the feet also provide information to the brain on position in space. Have your primary care physician or podiatrist assess your foot health, especially for diabetics. They can monitor your feet for any changes in sensation. If you notice any numbness or tingling in the feet, for instance as seen in peripheral neuropathy, contact your doctor to perform a comprehensive sensory examination to the feet.
  • Stay Active! Join a T’ai chi, Yoga, dance class or activities designed to promote flexibility, sharpen coordination and balance. Many of these activities can be modified for individuals of various physical levels and ability. According to the British Journal of Sports Medicine, a regular exercise program may improve protective responses in case of a fall. Being sedentary may not only put you at risk for obesity, heart disease and a whole host of other diseases, it prevents stimulation of the vestibular system, and it may also lead to decreased flexibility and strength, which are necessary for having good balance.

If you suspect difficulties in maintaining your balance, speak to your doctor about prescribing vestibular rehabilitation, a type of therapy specific to balance and dizziness disorders.

-Natasha Johnson, Sr. Physical Therapist
Certified Vestibular and Vision Specialist
St. David’s Rehabilitation Hospital

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