Balance better as you age

February 18, 2019 Providence Health Team

Proper balance has far-reaching effects on our health because it can keep our bodies and minds active

A history of falls is the biggest indicator of a balance problem

Usually, there is a medical condition that is the underlying cause of poor balance

In middle age, we tend focus on work/life balance. But as we age, the actual physical act of balance becomes much more important. That is because a simple trip or slip can have long-lasting consequences for our health.

“As many as one in three individuals over the age of 65 fall annually, and as many as 20% of those falls result in injuries that limit the ability to live independently,” says William Buxton, MD, director of neuromuscular and neurodiagnostic medicine and fall prevention at the Pacific Neuroscience Institute in Santa Monica, CA. “When that happens, people can’t engage in the activities they enjoy. We are finding that being engaged and involved in life is essential for helping our brains stay active and crucial for memory as we get older. Maintaining good balance as we age has far-reaching benefits.”

How to spot a balance problem

Often, people may assume that falls are just an unavoidable part of life as we get older. But Dr. Buxton says that doesn’t have to be the case. “They can be easily corrected and they are a sign that balance needs to be addressed to prevent another fall that could be much more catastrophic.”

The single best predictor for a balance problem is a history of prior falls, especially if someone has fallen more than once or hurt themselves in a fall. Until the problem underlying falls is fixed, they continue to be a risk.

“Other signs of balance issues include any feeling of unsteadiness,” Dr. Buxton says. “If people say that you look a little wobbly and ask if you need a cane, that’s a pretty good indicator of fall risk. Those are things a patient might notice, but in terms of things a doctor would notice, there could be a little weakness in the arm or leg, coordination problems or the patient’s vision is off.”

Check your risk for falling: Download the fall assessment questionnaire from the Pacific Brain Health Center.

How to fix and prevent balance issues

If you’re still young enough to think balance isn’t an issue for you yet, it’s actually the perfect time to take preventive measures. Perhaps the most important one is to exercise every day. Dr. Buxton recommends any type of activity that helps the legs get stronger and improves balance. 

“Walking is wonderful, unless somebody has had problems that would make it a fall risk, and weight-bearing exercise for the legs is also excellent,” he says. Other good activities include working out on an elliptical machine or tai chi, which Dr. Buxton says has scientific proof of working well. If you want to take up yoga or Pilates, make sure you practice under supervision or have your program reviewed and customized by your health care provider to make sure there aren’t any moves that would present a higher risk of a fall

The other crucial step towards better balance as you age is to keep up on all your doctor’s appointments. That doesn’t just means visiting your primary care physician for an annual physical or wellness appointment, but also regularly seeing your optometrist, cardiologist, and any other necessary health care provider, too. That’s because virtually every part of our body contributes to balance, Dr. Buxton says.

“Our brains and inner ears are critical for balance; vision is also important,” he says. “Our legs are important for the strength that comes from the muscles that support us. Those muscles need healthy input from nerves in our legs and back. The nerves in our feet are also important because they provide our brains with feedback that tells us where our feet are in space, so damage in the nerves can throw off our balance, especially in the dark. Our nerves to our legs have to travel through our spine, beginning in our necks, so even wear and tear in our necks can throw off our balance. Finally, having healthy hearts to provide our brains with adequate blood flow is also important for balance.”

If you have experienced falls or worry that you have a balance problem, it is important to get help. Dr. Buxton sees patients at the institute’s Brain Health Center, where the focus is on being mindful of fall risk and prevention. Physicians have detailed conversations with patients about their concerns and what situations tend to trigger their feelings of imbalance. There is also a detailed neurological exam that targets inner ear and brain function, strength and sensation in the arms and legs, vision, balance and coordination.

“Then we develop a plan to delve more deeply into any problems that are found, which can include blood work and scans of the brain and/or spine,” Dr. Buxton says. “We work with physical therapists and trainers, either in office or through referrals to outside providers if special care is needed. If any structural spinal problem or metabolic problem is found, we can refer patients to other specialists, often within the institute or Providence to get those other issues that may be affecting neurological function taken care of.”

Often, fixing the underlying issues solves a balance problem. That should be motivating enough to get help, because you shouldn’t have to worry about taking a spill and hurting yourself.

“The fear of falling can have a huge negative impact on your life and independence,” Dr. Buxton says. “It doesn’t cause balance problems but it can make you hesitant to get involved and engaged in activities that would be helpful for your balance. It’s something we really try to work with patients on and give them a specific plan to follow so they feel more comfortable on their feet.”

Learn more about neurology and neuroscience services offered at Providence St. Joseph Health:

CA: Pacific Neuroscience InstituteProvidence Neuroscience Services

OR: Providence Brain and Spine Institute; Brain Academy

WA: Providence Spokane Neuroscience InstituteProvidence Neuroscience Institute – Walla Walla; Swedish Neuroscience Institute

MT: Providence St. Patrick Hospital and Providence Neurology Specialists

AK: Providence Alaska Neuroscience Center

Recommended for you:

What you should know about preventing falls

Why older adults should review their medications

Preventing Falls is a Foundation of Healthy Aging

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This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.

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