Balance Problems in Elderly and How to Prevent Falls

Balance Problems in Elderly and How to Prevent Falls

Old age is one segment of human life where the concern for health and well being is re-thought. Here the basic principles of health as applied during adulthood do not fit in. A new set of conditions, managements and prevention strategies should be in place. Few conditions become rare at this age and few get commoner compared to the other counterparts of the life stages. Amongst such conditions falls in elderly need priority concern.

Causes of Falls

Falls are common accidents in geriatric population. These are attributed to frailty, reduced physical strength, poor performance, morbid conditions, lack of essential support, etc. Falls are one of the serious incidents which can be life threatening or result in increased morbidity. Identifying the reasons for falls and preventing them should be considered a priority in elderly care.

Why are falls common? When you ask a doctor the above question, he can come up with many common and uncommon reasons for the same. The causes ones which we could be able to prevent if intervened actively should be should be studied and understood well.

Common causes of fall in elderly include:

  1. Problems in balancing the body – due to problems in balancing apparatus of the body
  2. Poor eye sight – due to cataract, age related corneal changes, refractive errors which are very common in elderly
  3. Poor physical strength – as  part of natural ageing process involving poor muscle built and weakness
  4. Joint diseases like arthritis especially in joints of lower limb
  5. Syncope – secondary to Heart or Brain related conditions. Usually due to blockade in vessels supplying blood to either heart or brain. Even degenerative brain changes commonly seen in elderly can led to syncope and falls.
  6. Environmental factors such as the risky housing environment, poor physical strength not able to cope with harsh ecosystem.
  7. Elderly abuse, etc.

Balancing the body is one important function in the body which is also a defence mechanism against environmental factors which could lead to fall, also primarily to maintain necessary posture for walking and daily activities. This function is performed by an apparatus called vestibular apparatus present near the inner ear in the head. This works in co-ordination with the muscles of the body in maintaining the posture and balancing the body. Any defect to this apparatus can lead to imbalance and fall.

There are many conditions that affect the functioning of the vestibular apparatus leading to falls

  1. Presbyastasis – disequilibrium commonly associated with ageing with no clear explanation about poor performance by vestibular apparatus
  2. Vertibobasillar insufficiency – poor blood supply to the vestibular apparatus  
  3. Cervical vertigo
  4. Acute neuro labrynthitis – due to infections of inner ear
  5. Transient ischemic attacks – lack of blood supply to brain for short period

The above conditions should be looked at by a doctor and managed at the earliest to prevent falls. The other conditions mentioned as causes for fall too should be addressed during routine elderly check up which should be held at least once in every 6 months.


The house environment should also be made elder friendly by making below changes:

  1. Less number of stairs as possible, with short stance
  2. Railing to the stairs and side walls of big rooms
  3. Nonslippery floor tiles, especially in the bathroom
  4. Wall handles in toilets   
  5. Western system of commode in toilet
  6. Avoiding stoppers          
  7. Resting stations in each room of the house

Any such changes which help and enable the elderly to transit safely in the house environment should be used to prevent falls.

Regular health check-ups to prevent or manage the conditions which can cause fall including treatment of balance disorders should always be considered priority in elderly care.

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