Balance & Ageing - Why Good Balance Contributes to Healthy Ageing

Balance results from the combination of senses from a number of body systems; such as the eyes, ears, and the body’s sense of where it is in space.

How do our ears affect balance?

Our ears are a part of our vestibular and auditory system. The inner ear in particular, is a more complex structure than most people realise - including fluid-filled tubes and chambers. 

Specific nerve endings within this structure are able to recognise the head's position and movement, as well as sense the direction of gravity. The signals transmitted by the nerves in the vestibular system play a crucial role in the brain's capacity to maintain balance during standing and walking. These signals also allow us to see clearly while moving as they control the movements of the eyes.

Research has revealed that the number of nerve cells in the vestibular system tends to decrease around the age of 55. Additionally, blood flow to the inner ear decreases with age. If there is damage to the vestibular system because of this, a person may experience symptoms like dizziness, headaches, nausea, and difficulties with balance.

How do our eyes affect balance?

Our eyes are a part of our visual system. This system enables us to perceive and interpret the world around us through sight.

The eyes contribute to a phenomenon known as the ‘visual-vestibular reflex’, where visual signals interact with information from the vestibular system to stabilise our gaze and facilitate balance. This reflex is particularly evident during activities such as walking, where the eyes automatically adjust to maintain a stable focus on our surroundings, enhancing our ability to move smoothly, and avoid potential hazards.

By the age of 65, our eyes need three times more light than at 20-years-old, take longer to adjust to sudden changes in light and dark, are more sensitive to glare, and are less able to judge distance and depth. These can all contribute to an increased risk of falls, particularly when walking on uneven surfaces and structures like steps.

If the visual, vestibular and auditory systems are compromised, they can quickly cause problems with balance.

Examples of balance disorders

• Benign Paroxysmal Positional Vertigo (BPPV): Brief episodes of vertigo (spinning sensation) triggered by changes in head position, such as turning over in bed or tilting the head.
• Meniere's Disease: Recurrent episodes of vertigo, hearing loss, tinnitus (ringing in the ears), and a feeling of fullness or pressure in the affected ear.
• Vestibular Neuritis: Inflammation of the vestibular nerve, leading to sudden and severe vertigo, imbalance, nausea, and difficulty walking.
• Labyrinthitis: Inflammation of the inner ear, causing symptoms like vertigo, hearing loss, and ringing in the ears.

What can cause a balance disorder?

Common causes of balance disorders include:

• Medications
• Infections
• Inner ear problems, such as poor circulation or debris in the semicircular canals
• Brain conditions, such as traumatic brain injury

Increased fear of falling

Balance disorders can have a profound impact on emotional well-being. Chronic dizziness and imbalance can lead to anxiety, fear of falling, and eventually social isolation. The fear of falling, in particular, may cause people to limit their activities and movements, leading to a more sedentary lifestyle. This reduction in physical activity can further exacerbate muscle weakness and balance problems, creating a vicious cycle that negatively affects overall health.

How can Physiotherapists help?

Physiotherapists can assist with balance problems through exercise plans aimed at enhancing focus, balance and stability, and reducing the risk of falls. These exercises can also be useful in treating some of the secondary issues that come along with it, such as neck pain, tension, headaches, nausea, fatigue, and de-conditioning. For more information visit one of our Health & Wellness Centres, or give us a call on 1800 852 772.

Sources:

• https://vestibular.org/article/coping-support/living-with-a-vestibular-disorder/age-related-dizziness-and-imbalance/balance-aging/
• https://www.hopkinsmedicine.org/health/conditions-and-diseases/vestibular-balance-disorder
• https://brainstormrehab.com.au/balance-facts.html
• https://www.mayoclinic.org/diseases-conditions/balance-problems/symptoms-causes/syc-20350474