Caring Currents

Get Tested for Inner Ear Balance Disorders to Prevent Falls

Last updated:

May 27, 2009
Image by h.koppdelaney used under the creative commons attribution no derivs license.

Yesterday the Journal of the American Medical Association made a surprising announcement: More than a third of adults over age 40 suffer from an inner ear balance disorder that puts them at risk of falling.

When researchers at Johns Hopkins University Medical School analyzed data from more than 5,000 adults over age 40, they found that 35 percent failed a series of balance tests and reported a history of dizziness and falls.

The diagnosis: "vestibular dysfunction," which means a balance problem caused by changes in the inner ear that can occur with aging. This news resonated with me because my step mom, the most active sixty-something woman I know, has been sidelined by dizziness that prevents her from flying, exercising - even walking her dogs. She can't even drive, which is an astonishing liability for a woman in her mid-60s who's traveled all over the world.

So I found this study fascinating, and feel very motivated to try to find out what might help. The vestibular system, which controls balance, consists of two organs within the temporal bone at the side and base of the skull that relay information to the brain about head motion and orientation relative to gravity.

The authors of the study called for widespread screening tests to be given to older adults so people with inner balance problems would be aware of them and could seek treatment rather than be at risk falling.

How do you know if you or a family member has an inner ear balance problem?

Initial testing is fairly simple. The doctor will have you stand on a variety of surfaces with your eyes open and then with your eyes closed. You could try this simple test at home: Walk across the room. Now do the same thing with your eyes shut. Do you feel severely impaired?

It's also important to pay attention to how often you or older family members notice vertigo or dizziness, even if it's only episodic, as you go through your normal daily routine.

Are Inner Ear Balance Problems Treatable?

Treatment for inner ear balance problems depends on the cause of the problem. People who have BPPV (Benign paroxysmal positional vertigo), which accounts for about 20 percent of all cases of inner ear dizziness, swear by a new procedure called the Epley maneuver -- also called canalith repositioning procedure (CRP). BPPV is caused by a buildup of tiny calcium carbonate crystals in the inner ear, and the CRP effectively repositions the crystals.

Treatment for other types of vestibular dysfunction typically starts with specialized physical therapy called vestibular rehabilitation therapy. Working with a specialized therapist, you learn a series of exercises to retrain the brain to recognize and process signals from the inner ear.

There are also several medications that your doctor can prescribe, alone or in combination, to treat various types of vestibular dysfunction. And as a last resort there are also surgical options.

The main thing is to get tested and get help if you or someone you love does indeed have a balance problem. Falls are one of the most serious health issues as we age because broken bones can lead to a cascade of health problems. According to the Centers for Disease Control, falls are the leading cause of injury deaths among older adults and are also the most common cause of hospital admissions for trauma.