People may begin to lose their sense of balance as they age or develop chronic health conditions. This can lead to falls that can cause injuries. Andy Beltz, PT, DPT, therapy assistant manager at Aultman Tusc, explains why this can happen and discusses how to get help.

It’s probably not news that as we age, our bodies change. Some changes like gray hair or wrinkles are noticeable, while other changes can be more subtle. We might not notice a decline in vision or hearing – until it’s discovered in an annual screening test.

This is because our bodies are remarkably good at adapting to gradual changes, and we don’t notice until there is a problem. Several studies confirm our tendency not to notice hearing or vision changes that occur over time. A recent study found that self-reported vision problems often fail to identify objectively measured visual impairment in older adults.

Similarly, research published in JAMA Network Open found that many older adults with measurable hearing loss did not report having hearing difficulties when compared with formal audiometric testing.

The same thing can happen with our balance.

Many people are surprised to learn that we have important balance sensors in our feet. These sensors constantly provide information to the brain about where we are, how we are moving and what type of surface we are standing on.

As we age or develop certain health conditions, these sensors may not communicate with our brains as effectively. When this happens, we may notice that we trip more often, feel unsteady or experience a loss of balance.

The medical term for this condition is sensory neuropathy, but many people simply describe it as feeling "off balance" and have no idea why. One of the first clues is having difficulty maintaining balance when vision is limited. Some people become unsteady when the lights are off or while showering with their eyes closed. These may be signs that sensors in the feet are not communicating with the brain the way they once did.

Why is balance so important? The ability to stay steady on our feet as we age reduces the risk of falling. A fall can cause minor injuries like bruises and fractures of small bones. Falls also cause major injuries like broken hips or head injuries.

These major injuries can lead to surgery and hospitalization. Among older adults, falls are the most common cause of traumatic brain injuries.

The good news is that balance problems are not always something you just have to live with. Identifying the cause is the first step. A physical therapist can evaluate your balance, determine which systems may be contributing to the problem and help develop a plan to improve your safety and build your confidence in everyday activities. This plan may include physical therapy, vestibular therapy and prescribed exercises at home.

If you have noticed changes in your balance, don't ignore them. Sometimes what seems like a normal part of aging is actually your body's way of telling you that one of its important balance systems needs attention. Aultman Therapy Services can help you find out how to improve your sense of balance – and maybe prevent the next fall.

Sources:
The Staywell Company, LLC
Potter T, Almidani L, Diaz M, et al. Concordance between self-reported visual difficulty and objective visual impairment. Ophthalmology. 2024;131(12):1447-1456.
Tsimpida D, Kontopantelis E, Ashcroft D, Panagioti M. Comparison of self-reported measures of hearing with an objective audiometric measure in adults in the English Longitudinal Study of Ageing. JAMA Network Open. 2020;3(8):e2015009. doi:10.1001/jamanetworkopen.2020.15009.