Balance, Vertigo and Ageing

It is common for older people to become hard of hearing as ageing affects the sensory apparatus in the ear. Most people are aware of this but perhaps don’t realise that ageing can also impact on the balance function of this part of the ear, resulting in vertigo, dizziness and an increased risk of falling.

Inside the inner ear, the cochlea is responsible for sensing changes in pressure caused by sound waves coming into the ear from the environment. This organ is associated with the semicircular canals, and the interconnecting vestibule, which together enable us to stand upright and to maintain our normal balance. The utricle and saccule, the actual sense organs for balance, are contained within the vestibule.

The nerve cells and receptor cells in the utricle and saccule degenerate with age, just like those in the eye and in the cochlea. People over 60 tend to experience loss of balance, dizziness and vertigo much more often than people under 60, usually because the vestibular apparatus is not working as well as it used to.

Symptoms of Ageing and the Vestibular Apparatus

As well as feeling dizzy and losing balance and falling, there are many other symptoms of inner ear problems. Walking and keeping a good balance can be difficult, even if the person affected does not have an specific episodes of dizziness – in some people, early problems with the inner ear can present as being clumsy or uncoordinated and so go unrecognised until they get much worse.

Some people find that they are looking at the floor more often to gain visual clues about their position and find it very difficult to retain their balance in the dark. They can be very uncomfortable about their ability to balance on an unfamiliar flooring surface, or even when they have new shoes. As the problem gets worse, some people feel the need to hold their head when they are sitting down, as it tends to tilt, or get into the habit of walking around their home constantly holding on to different supports and objects.

Dizziness and Vertigo

Episodes of dizziness and vertigo can be upsetting but the distress increases if this sensation is present for much of the time. People who have constant vertigo find it very difficult to concentrate on ordinary tasks and they become very confused, leading to misdiagnosis of age-related cognitive problems. The affected person can become phobic about going out, in case they fall, and panic, depression and anxiety are common associated symptoms.

Sometimes, the degeneration of nerve cells in the vestibular apparatus causes nausea and sickness – the person affected may feel seasick, or as if they have a hangover, with slurred speech and perhaps strange sensations inside the ears. Their symptoms can become worse if they experience loud noises and may even fall over after hearing a sudden loud noise. It is also common for hearing-related symptoms to be experienced, such as hearing that comes and goes, and tinnitus.

Impact on Quality of Life

Being unable to balance properly because of age-related changes in the inner ear can affect quality of life very severely. Not only does it increase the risk of injury due to falls, it also prevents mobility, it can lead to inactivity and it is also associated with greater social isolation in older people. Not being able to balance makes going out difficult, driving impossible and leads to depression and loss of self-esteem.

Treating Inner Ear Balance Problems

Problems caused by ageing can be difficult to treat but Valium can be helpful as this decreases inflammation in the vestibular system and also acts on anxiety. If the underlying cause of the vertigo is thought to be a viral infection, this can be treated, and some conditions such as labyrinthitis, in which debris builds up in the vestibular apparatus, can be treated by head manipulation. Otherwise, coping with dizziness and vertigo involves behavioural changes such as using a stick or cane, if that helps you walk more easily, and focusing on objects in the distance. Some doctors may advise a neck collar to keep your head straight to try to ease the vertigo.