Causes and treatment of balance complaints in the elderly

Many elderly people suffer from balance problems. They suffer from dizziness, light-headedness, vertigo and they are not steady on their legs. The causes can be different. Medication use, a sharp drop in blood pressure, illness or inflammation and too little exercise affect balance. Balance problems cannot always be prevented or remedied, but they can be reduced by doing exercises that improve the function of the balance organ. Safety in and around the home is also important. It can prevent a fall.

The organ of balance

The organ of balance is located in the middle ear. This organ is very vulnerable and is therefore located behind the petrous bone. It consists of two parts: the semicircular canals and the otolith organs. These transmit information to the brain that allows you to maintain your balance while standing and doing activities.

Common balance complaints are:

  • A light-headed feeling.
  • Dizziness, blurred vision, black spots in front of the eyes.
  • Standing unsteadily on your feet.


What causes balance problems in the elderly?

There are various factors that can influence the development of balance complaints. Common factors include:

Low blood pressure

Dizziness, blurred vision and black spots in front of the eyes are complaints that occur when you get up too quickly. The brain does not receive enough blood for a while due to the temporary drop in blood pressure. This is restored as soon as the blood vessels narrow and blood pressure rises again. With persistently low blood pressure, complaints can be the cause of instability, causing you to lose your balance more quickly.

Reduced physical fitness

As one gets older, physical condition decreases. The joints become stiffer and limbs become stiffer. Muscles weaken, resulting in reduced strength and movement requiring more effort and energy. An impending loss of balance is less easy to prevent because reaction capacity is also reduced.

A disease or inflammation

Diseases such as diabetes, dementia and Ménière’s disease can be the cause of balance problems. A sharp drop in blood sugar levels (less than 3.8 mmol/l) in diabetes is called hypoglycemia. Symptoms such as dizziness and fainting occur. Ménière’s disease affects the balance organ. This causes dizziness, nausea, vomiting, tinnitus and hearing loss. Memory loss in dementia is accompanied by disorientation and balance disorders. An ear infection can cause (temporary) balance problems.

Vision deteriorates

Vision deteriorates due to eye complaints such as cataracts, old age or increased eye pressure. Problems with balance arise because you cannot see where you are putting your feet.

The use of medications

The side effects of certain medications can cause balance problems. These include medications that lower blood pressure, muscle relaxants, sleeping pills and diuretics.

Safety at home

A safe environment prevents falls. A home becomes safer:

  • If there are not too many things. Ensure there is sufficient walking space and clear away unnecessary items.
  • By arranging furniture in such a way that they can provide support in the event of unexpected dizziness.
  • By removing loose rugs and storing cords. Would you like a dress? Then choose a rug with anti-slip on the bottom.
  • Without barriers.
  • With high chairs and sofas and a high bed to make getting up easier.
  • By using good lighting.
  • By attaching supports to the wall. This can be done, for example, in the bathroom, toilet, next to the bed or at a step.
  • By installing a stair lift if climbing stairs is difficult.


Is it possible to reduce balance complaints?

Unfortunately, balance complaints cannot always be prevented. However, you can do something to reduce them yourself.

Keep moving

Exercise is important for maintaining good fitness and improving your sense of balance. With too little exercise, the muscles relax and it is more difficult to maintain balance. All forms of exercise help: walking, cycling and doing exercises. Half an hour of exercise a day is sufficient. This does not have to be consecutive, three times ten minutes is also allowed. Try to alternate sitting by walking around regularly. This can be done around the house. A physiotherapist can help by providing exercises that strengthen the muscles. But also by practicing walking together if there is a fear of falling.

Get up slowly if your blood pressure is low

Low blood pressure causes dizziness when standing up too quickly. This can be prevented by getting up slowly. When getting out of bed, it is better to first sit down, wait a while and then stand up. If necessary, use support when getting up. The dosage of medication may be adjusted in consultation with your GP. Blood pressure lowering drugs can cause severe dizziness.

Use tools

Sturdy, flat shoes provide support in finding good balance. A walking stick or rollator can provide extra support while walking. Also have your eyes measured every year (from the age of 60) so that vision loss is corrected in time. Vision improves with good glasses.

Regular monitoring for diabetes mellitus

For people with diabetes mellitus, it is important that blood sugar levels remain as stable as possible. Visit your GP or practice nurse regularly for check-ups.

Limit the use of sleeping pills and alcohol as much as possible

The balance organ is overstimulated by the use of alcohol, resulting in dizziness. Alcohol also affects motor skills. You are less steady on your feet. Once the alcohol has worn off, the symptoms disappear again. Sleeping pills cause dizziness, drowsiness, sluggishness, concentration problems and muscle weakness. Older people who use sleeping pills fall more often.

Seek help for psychological problems

Stress, anxiety, loneliness and sadness can cause balance problems. And these complaints can reinforce feelings of fear, loneliness and gloom, creating a downward spiral. By talking about these feelings and looking for a solution (together with, for example, a psychologist), complaints can be reduced.

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