Q: I have an older friend. He is in his 80s and he is very fit and strong for his age, but he seems to have problems with his balance. He recently tripped over a garden hose and fell. Luckily, he did not do any damage except for a bruise on his leg. What causes balance problems?
A: There is a simple test you can do to test your balance. Try to stand on one leg for at least 10 seconds. Researchers in Brazil, led by Dr. Claudio Gil Araujo, a sports medicine specialist, found in a recent study that nearly one in six people who were unable to complete this simple test died within a decade, compared to only one in 22 of those who passed the test. They took into account such factors as poor health and obesity.
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Some people think that the inability to balance is due to weak muscles and poor physical strength, but you state that your friend is fit and strong. Maybe there is something else happening in the brain. The inner ear is also involved in controlling balance and a dysfunction can lead to vertigo and falling.
Benign paroxysmal positional vertigo occurs when calcium crystals in your inner ear are dislodged from their normal positions and move around in the inner ear. This condition is the most common reason for vertigo and dizziness in adults. It is often first noticed when turning over in bed.
Another ear disease known as Menieres disease may also be to blame. It is characterized by the triad of symptoms: dizziness, tinnitus-ringing in the ears and deafness. No one knows what causes it, but it usually starts earlier in adulthood.
Temporary light headedness or faintness may also lead to stumbling or falling as blood pressure suddenly drops in certain circumstances. There could be a heart rhythm condition where the heart skips beats or reduced blood flow due to other types of heart problems.
Postural hypotension is also common in older individuals, particularly those on blood pressure medications. This causes a sudden drop of blood pressure when the person changes from a sitting or lying to a standing position. Other medications may also have this side effect.
Cerebellar ataxia is another less likely possibility. It causes unsteadiness and a staggering type of gait, but there are other symptoms such difficulty with hand eye co-ordination, double vision and slurred or imprecise speech.
The cerebellum is found at the bottom of the brain and can be injured during a head injury or affected by various viruses and diseases such as MS.
The post-viral type or acute cerebellar ataxia is usually found in children and generally resolves in a short time without treatment.
