Why does balance decline with age?

DEAR DOCTOR K:

In a previous column you wrote about the importance of balance exercises as we age. But why does our balance get worse as we get older?

DEAR READER:

A number of changes that come with aging can affect our balance.

  • Inside our ears is a balance center called the vestibular system that detects where our body is in space. Are we upright or lying flat; are we standing on our feet or performing a handstand?
    The vestibular system is connected to centers in the brain that also control our balance. When the vestibular system and brain determine that we’re about to fall over, the brain directs the body to take corrective action. Maybe we twist back upright so we don’t fall. Maybe we’re too far off center to avoid falling, so our arms and hands stretch out to brace our fall.
    As we age, cells in the vestibular system die off. This affects how accurately we detect our position in space. That, in turn, affects our ability to correct our position. For example, if we start to tilt to the right and the vestibular system doesn’t detect this quickly, it becomes harder for the brain to prevent falling to the right.
  • Our sight, the ability to focus and see things clearly, diminishes with age. So do depth perception, night vision and sensitivity to contrast. Eye problems can impair, blur or distort vision. The loss of these visual cues compromises balance. Corrective lenses or surgery may help.
  • Blood pressure can dip suddenly when you stand up, causing dizziness, lightheadedness, blurry vision, even fainting. Standing up slowly — sitting first on the side of the bed when you rise, for example — may help.
  • We lose a lot of muscle mass and strength as we age. We also lose power — a function of strength and speed — which affects balance, too. If you start to trip, power helps you react swiftly. Exercise can help you rebuild strength and power, or at least slow the pace of decline.
  • Our reflexes and coordination slow with age. Thus, you may be more likely to stumble — and take more time to react when you do.

Many health problems can interfere with balance. They include, but are not limited to, arthritis, stroke, Parkinson’s disease and multiple sclerosis.

Medications may also increase your risk of falls. They can cause blurred vision, dizziness, lightheadedness and drowsiness. Some medications may damage the inner ear, spurring balance disorders.

Along with regular aerobic exercise and weight training, balance exercises are important as we get older. Such exercises really can help you improve your balance. I’ve posted some of these simple exercises before, but I think it’s worthwhile to highlight them again, so I am including them below.

Beginner Balance-Training Exercises

These exercises are a good first step towards improving shaky balance. They can be done by people of many ages and abilities, including those who are elderly, frail, or recovering from illness or surgery.

Get up and go

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Reps: 10

Sets: 1

Intensity: Light

Tempo: 2–4–2

Starting position: Sit up tall in a chair. Lift your chest, keeping your shoulders down and back. Brace your abdominal muscles and bend your elbows, palms toward each other.

Movement: While exhaling, roll your shoulders further down and back, away from your ears. Turn your arms out so your palms face forward, squeezing your shoulder blades together. Hold. Slowly return to starting position.

Tips and techniques:

  • Think of squeezing a tennis ball between your shoulder blades.
  • Keep your spine neutral and brace your abdominal muscles throughout the movement.
  • Breathe comfortably.

Too hard? Squeeze your shoulder blades together gently.

Too easy? Hold squeeze for eight counts and do three sets.

 

Standing side leg lift

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Reps: 10 on each side

Sets: 1-3

Intensity: Light to moderate

Tempo: 2-2-2

Starting position: Stand up straight behind a chair, holding the back of it with both hands. Put your feet together and evenly distribute your weight on both feet.

Movement: Slowly lift your right leg straight out to the side about 6 inches off the floor. Hold. Return to starting position. Finish all reps, then repeat with the left leg. This completes one set.

Tips and techniques:

  • Exhale as you lift your leg.
  • Keep your shoulders and hips aligned throughout the exercise.

Too hard? Just touch your foot out to the side on the floor.

Too easy? Hold your leg up for eight counts, or close your eyes.