Certain health conditions, medications, and environmental factors can negatively impact balance and increase the risk of falling.‍

Our balance drops as we age, putting us in jeopardy. The problem reflects a mix of issues that set us up for falls, which are a major cause of hip fractures, head injuries, and disability. The good news is that you can fight back by recognising and addressing potential balance busters. Everything we do to maintain our health, alertness, fitness, and mobility will slow the trajectory of our declining balance. ‍

What is balance?‍

Your body's balance system is a complex and intricate process that involves multiple parts of your body working together. Your eyes provide information about your location in space, balance organs in your ears detect head movements, and nerves communicate information about the position of your body. Your brain processes all of these signals and sends messages to your sensory nerves, muscles, and joints to help you maintain balance and perform activities like walking, keeping your gaze stable, or catching yourself after stumbling.

As we age, the various components of our balance system can become less efficient. Our vision and hearing may not function as well, messages in our nerves may become distorted, muscles may become weaker and smaller, joints may become worn out, and our brain may not be as quick to make necessary adjustments to maintain balance. All of these factors can contribute to a decline in balance as we age.‍

Health-related balance risks ‍

There are various health conditions that can negatively impact balance. Some common examples include:‍

1. Vision Problem‍

Certain eye diseases can affect the ability of the eyes to transmit information about location to the brain, which can compromise balance. Some common eye conditions that become more prevalent with age and can impact balance include cataracts (cloudiness of the eye lenses), glaucoma (which causes loss of peripheral vision), and macular degeneration (which damages central vision).‍

2. Inner ear conditions‍

Vertigo, a sensation of spinning, can be caused by various disorders that affect balance organs. Some examples of these disorders include benign paroxysmal positional vertigo, which is caused by loose ear crystals; inner ear infections; and Ménière's disease, in which fluid accumulation leads to pressure and damage in the inner ear.‍

3. Neuropathy‍

Peripheral neuropathy is a type of nerve damage that can result in tingling, numbness, or pain in the limbs. It is often caused by diabetes or compressed nerves in the spine. This damage can affect the brain's ability to sense the legs and feet.‍

4. Foot conditions‍

Maintaining good balance is crucial for overall mobility and stability. However, there are many different factors that can threaten your balance. For example, any issue that affects the way you walk, such as a heel problem or fallen arches, can impact your balance. Additionally, certain disorders and medical conditions, such as vertigo and peripheral neuropathy, can also impair balance. It's important to address these issues and seek treatment if necessary in order to maintain good balance and prevent falls.‍

5. Orthostatic hypotension‍

Orthostatic hypotension is a condition in which a person's blood pressure drops too low when they stand up, causing dizziness and an increased risk of falls. This condition becomes more common with age and can be a side effect of certain medications.‍

6. Mild cognitive impairment‍

Mild cognitive impairment is a common condition that can occur as people age and is characterized by a decline in memory and thinking skills. It is often considered a precursor to more severe forms of dementia, such as Alzheimer's disease. However, not all people with mild cognitive impairment will go on to develop dementia. The condition can affect a person's ability to remember new information, pay attention, and make decisions. It can also impact their reaction time and sense of spatial awareness. It's important to pay attention to any changes in cognitive function and discuss them with a healthcare professional.‍

7. Medication-related balance risks‍

There are many medications that can cause dizziness and imbalance, including:

• Some antidepressants
• Drugs to treat anxiety (such as benzodiazepines)
• Antihistamines
• Blood pressure drugs (such as ACE inhibitors, angiotensin-receptor blockers, and beta blockers)
• Diabetes drugs (such as insulin, glipizide, and glyburide)
• Drugs to treat irregular heartbeat
• Prescription pain medications (such as opioids)
• Sleep medications (such as sedatives and hypnotics)

Environmental balance risks

There are many hazards in your environment that can threaten your balance and increase your risk of falling. Some examples include:‍

Outdoor hazards that can affect your balance and increase your risk of falls, including:

• Icy walkways
• Uneven pavement
• Poorly lit walkways or parking lots
• Paths blocked by shrubs or large tree roots

Indoor hazards that can affect your balance and increase your risk of falls, including:

• Floor clutter or obstacles in your path
• Throw rugs
• Poorly lit hallways or stairways
• Furniture that blocks your path
• Extension cords
• Loose carpeting
• Loose handrails
• Slippery bathroom floors
• Broken steps
• Tile floors‍

What you can do‍

There are many steps you can take to improve your balance and reduce your risk of falls. One of the first things you can do is to assess your home environment and identify any hazards that may increase your risk of falls. This may include things like cluttered floors, throw rugs, poor lighting, and slippery surfaces. You can also consider adding anti-slip equipment and safety features to your home, such as grab bars in the bathroom, nonslip treads in wet areas, night lights to improve visibility, and handrails to support your body weight. These simple changes can go a long way in helping to prevent falls and maintain good balance.

There are many steps you can take to improve your balance and reduce your risk of falls. One of the first things you should do is talk to your doctor about any health problems or medications that may be increasing your fall risk. 

Your doctor may recommend physical therapy or suggest that you use an assistive walking device, such as a cane or rollator, to improve your balance. Wearing supportive shoes with laces can also help to keep your feet secure and improve your balance. You can also work on improving your balance skills by challenging yourself in a safe way. 

For example, you can try standing on one foot while brushing your teeth in the morning and then standing on the other foot while brushing at night, using the stairs instead of the elevator, and engaging in balance-enhancing activities like walking, cycling, tai chi, yoga, or dancing. 

Remember that good balance is a "use it or lose it" proposition, so it's important to use and challenge your balance regularly.