Many older adults face balance problems

DEAR DR. ROACH >>

I am 79 years old, male and in good shape. The only medication I take is 20 mg of Lipitor daily. Approximately five years ago, I fell off a small ladder. The fall was caused because I lost my balance. From that time on, my balance has worsened. I notice that when I lose my balance, most of the time I fall backward. I consulted an ear, nose and throat specialist, whose results came back negative. I met with a neurologist, who arranged for an MRI of my brain, which came back normal. Have you any suggestions?

Geriatricians have special expertise in preventing falls, as well as improving overall function in older adults.

DEAR READER >> Balance problems are extremely common in older adults, and often, a single cause cannot be found. Falls happen in about a third of older adults in the community every year.

A comprehensive evaluation is appropriate. This includes not only the studies of balance and strength that I’m sure your ENT and neurologist did, but a vision assessment, checking the heart and the blood pressure both standing and laying down, a foot inspection and review of medications (Lipitor is NOT one of the many drugs commonly associated with falls). A vitamin D blood level may be useful, with supplementation for those with low levels.

If the evaluation yields no identifiable cause for falls, my personal practice is to refer to physical and/ or occupational therapy. These professionals have expertise in helping prevent recurrent falls. They may also recommend strength and balance exercise. Tai chi, in particular, has been shown to reduce fall risk.

Geriatricians have special expertise in preventing falls, as well as improving overall function in older adults.