Falls are a major health issue in the elderly.
For the United States, the Centers for Disease Control report that 36 million falls every year are reported for American adults over the age of 65. Since there are 54 million senior citizens in the USA, this means that, on average, an elderly person has a 2 out of 3 chance of taking a fall every year.
Of those 36 million falls by older adults in the US every year, 3 million necessitate a trip to the emergency room for broken bones or a head injury. About 285,000 older adults in the USA every year suffer broken hips, usually by falling sideways. About 36,000 older Americans every year die as the result of falls.
Falls are also a huge health concern for older Canadians. Health Canada estimates that one in three Canadians over the age of 65 will take a fall in any given year, and one in three Canadians who have to be hospitalized for falls are discharged to long-term care.
Maintaining good balance is critical to avoiding falls, avoiding broken bones, avoiding admission to nursing homes, and staying alive. The bad news about balance issues for seniors is that there is a long list of conditions that can cause them.
What Causes Balance Issues in the Elderly?
Older people develop health conditions that result in balance issues. In this article, we will only have space to consider the most common of them.
One of the conditions that affects many of the oldest old that results in balance issues is failure to thrive.
Failure to thrive isn’t so much a disease as it is a set of symptoms that reflect profound deterioration of general health. Older adults described with failure to thrive often don’t have a good appetite and have lost more than 5 percent of their body weight. They tend to get dehydrated (which can cause death in just a day). They get infections. They become immobile. They are depressed. And when they don’t eat enough protein to keep up their muscles, they tend to fall.
From 5 to 35 percent of elderly people who live independently develop failure to thrive. About 28 percent of nursing home residents in Canada and 35 to 45 percent of nursing home residents in the United States are diagnosed with the condition. In the US, 50 to 60 percent of veterans in hospitals are diagnosed with failure to thrive.’
Another common cause of falls in the elderly is lack of circulation. The problem that results in falling is not so much bad arteries as bad veins. People who have peripheral arterial disease usually suffer significant pain when they walk, so they don’t have as many opportunities to fall. People who have venous reflux disease have stinging, burning, and aching when they don’t walk, and are more likely to take falls.
Falls can result from a condition called postural hypotension, or orthostatic hypotension. Diuretics (“pee pills”) are used to treat some cases of high blood pressure and most cases of congestive heart failure. They change fluid balance in the ear, so that the patient loses balance when moving from sitting down to standing up.
Falls are not especially common in this condition, but they are a real risk. The good news is that this symptom usually goes away as the medication brings blood pressure to normal levels or significantly relieves congestive heart failure.
Diabetics are prone to falls. They may suffer falls when their blood sugar levels are low. After 10 to 25 years of poorly controlled diabetes, most diabetics develop a kind of nerve damage called neuropathy. They lose feeling in their feet, and are more prone to slipping and falling.
Falls are more common in people who have iron deficiency anemia and in people who have neurological conditions like Parkinson’s disease or multiple sclerosis. Falls may be provoked by a long list of medications.
All of these conditions are alike in that if the underlying condition is brought under control, balance issues fade away. But there is a set of conditions that audiologists see on a regular basis in which balance issues aren’t a symptom of the disease, they are the disease.
How Your Ears Can Relate to Your Balance
One of the most common causes of balance issues in the elderly is a condition formally known as idiopathic endolymphatic hydrops, which has symptoms that overlap with Ménière disease and Ménière syndrome. The difference between the diseases basically is that Ménière disease and Ménière syndrome have known causes, while idiopathic endolymphatic hydrops doesn’t.
These conditions result from a buildup of pressure in the inner ear, which in turn interferes with the ear’s ability to send signals to the brain when you shift position. They are affected by hormonal imbalances, excessive or deficient consumption of sodium, infections, injuries, and even food triggers.
About 1 in 100 seniors develops one of these conditions. They are rare enough that nobody should just assume they have them, but they are common enough to require diagnosis by audiological testing. Your audiologist like Harbor Audiology & Hearing Services is the place to start if you suffer balance issues, and you do not have any of the other conditions mentioned above.
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