Health Matters: Preserving balance in the later years of life

According to the U.S. Center for Disease Control and Prevention, one out of four American adults age 65 and older experiences a fall each year. Many older adults recognize they confront challenges with stability and are at risk for falling but are unsure how this came to be and what, if anything, to do about it. Although it is easy to blame these changes on simply “getting old” and view them as inevitable, there are conservative measures you can take to mitigate the effects of aging on balance.

Common factors that affect balance in the later years of life include de-conditioning of your sensory systems as well as physiologic changes in nerve and muscle tissue that respond to messages from your brain. In each of these cases, focused exercise can have a substantial impact on improving your steadiness and increasing your confidence with movement.

To maintain balance your brain must collect and integrate sensory information from your eyes, from receptors in your joints that sense body position and from equilibrium sensors in your inner ear that detect head movement and positioning. The brain assimilates this input to determine which signals to send back to your muscles, causing adjustments in body position to prevent a loss of balance. Often the performance of one or more of these sensory systems begins to diminish with age, sometimes due to not engaging them properly. A common mistake made by people who start to mistrust their balance is to reduce their activity level out of a fear of falling. However, avoiding movement robs your senses of the adequate input and activity they need to stay sharp and ready for action.

Physiological changes in nerve and muscle tissue are important to consider as well. Starting as early as your late thirties you begin to lose muscle mass, which leads to a decrease in strength. As muscles weaken they lose their power or ability to contract quickly. A muscle that is weak and slow to respond is unable to adequately support and stabilize your skeleton or respond effectively to sudden changes in the environment. However, a regular routine of strength training and cardiovascular exercise can have a substantial impact on reducing the loss of muscle mass as well as improving the strength and endurance of your muscular system.

Flexibility also affects balance. Inactivity leads to muscle stiffness and decreased joint mobility. A rigid body is more likely to lose balance and less likely to successfully adapt to and correct a loss of balance. Although stretching exercises are helpful, simply getting enough movement through out your day plays a huge part in maintaining adequate flexibility.

In addition to muscles, the tissue surrounding your nerves can begin to deteriorate with age. A nerve that is not properly insulated suffers a slower conduction rate, meaning your reflexes and coordination are negatively affected. Yet just as our muscles can get stronger with strength training, so can our balance improve with the practice of challenging or “exercising” your neural pathways. A regular schedule of performing balance exercises can help reinforce and strengthen the pathways that respond to a loss of balance, thereby improving the likelihood of being able to correct yourself when a loss of balance occurs.

A number of recent research articles have demonstrated the positive effects that strength, flexibility and balance training can have on improving the steadiness of older adults. In 2014 the Shanghai University of Sport published an article in The Journal of Sport and Health Science that examined the effects of a 24-week tai chi chu’an exercise program on the balance of 38 males ages 55–65. Tai chi is a form of martial arts that requires strength, mobility, balance and coordination to perform. The results showed a statistically significant improvement in the participants’ ability to perform balance exercises such as standing on one leg and closing their eyes.

It is important to note that balance can also be affected by a number of medical factors, including cardiovascular insufficiencies, neurological abnormalities and inner ear disorders, as well as side effects from medications. If you are experiencing issues with balance or dizziness, consult your physician. In addition to engaging with exercise forms such as tai chi, your doctor may recommend working with a physical therapist who can teach you exercises to help improve your stability and decrease your risk of falling.

Our ability to move with confidence is closely intertwined with our quality of life and sense of wellbeing. Don’t let getting older make you feel resigned to inactivity. Talk to your doctor about appropriate resources to help keep you moving, steady and safe.

Laurel Lakey lives in Charlotte and works as a physical therapist assistant at Dee Physical Therapy in Shelburne. You can reach her with comments and questions by email.