Dizziness and Safety

Do you ever feel like you just got off a crazy ride when you are nowhere near the county fair? Dizziness becomes more common with age, but you don’t need to visit the county fair to initiate the feeling. Vestibular problems, or dizziness, grows in frequency after age 65. Balance disorders are a compelling problem because of the increased risk of falling. Falls among the elderly result in approximately 1.6 million emergency room visits yearly, and are the 6th leading cause of death in older adults. Approximately 60% of falls occur in the home.

The human body relies on the input from at lest three independent systems to interpret its position in space and regulate balance.  It then coordinates righting reactions and stabilizing movements through muscle activity. The inner ear, or Vestibular System, provides feedback to the brain about the head’s movement through space. Vision gives us a sense of where we are in relation to our surroundings, and nerves in our muscles, joints, and skin give us a sense of position or “proprioception.” Take any one of the three away, and balance is impaired.  It’s not in the literature that I can find, but I believe that our hearing plays a role in equilibrium as well.  Perhaps I should perform some research in that area!

There are ways to improve balance, and to treat vestibular disorders. A vestibular disorder called vertigo is recognized when the world appears to be spinning, when in fact you are holding still.  There are many causes for vertigo, including crystals or swelling of the fluid in the inner ear, as well as inflammation of the nerve to the inner ear.  An “Epley Maneuver” will quickly treat vertigo caused by changes in head position, while head and eye exercises can greatly improve vertigo that is due to swelling or nerve problems.  Other types of imbalance include light-headedness, instability, and loss of position sense.  The proper exercises are key for training your body to react to the inputs; balance training is essential.

For safety’s sake there are several ideas that should be considered, especially if someone in your home who is at risk to fall.  For example: rooms and hallways should be well-lit, stairs should have handrails, and vision checks should be done on a regular basis. Grab bars in the bathroom can be a big help. Throw rugs are a constant threat, as they make it easy to snag to the foot. Finally, have your family doctor perform a medication review, as there are many medications that can cause unsteadiness.

 I need to give some credit on this post to my colleague Tony Stump.  We published an earlier version of this article in a couple of places, and I can’t remember which part of it I wrote, and which part he wrote (old age creeping in).

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