Inner-ear problems put many seniors at risk of falls

It's a story that's all too common. An older man or woman was living independently and in reasonably good health—until having a fall. A misplaced step or dizzy spell led to broken bones, months of rehab, lasting disability, and possibly even death. For seniors, the physical, mental, and emotional toll of these injures can be devastating, as can the financial cost, with more than $20 billion spent on fall-related injuries in the United States each year.

So why do so many older people fall? Dizziness from inner-ear problems is thought to be a key culprit. Now, the first large study has looked at how common these problems are and how closely they're linked to the risk of falls.

To collect data, the researchers tapped into the National Health and Nutrition Examination Survey (NHANES), which regularly polls thousands of Americans on health-related issues. Participants also underwent a physical exam, including balance testing. These tests are designed to spot inner-ear problems (called vestibular dysfunction), which can throw off your sense of balance and make you dizzy.

The researchers found that 1 in 3 adults over age 40 had signs of inner-ear dysfunction. This translates to 69 million people nationwide. And nearly a third of the people in this group (more than 22 million people) were unaware of their balance problems, as they'd had no symptoms suggesting anything was wrong. These people were three times more likely to have a serious fall than those with a healthy sense of balance. And the risk of falls was 12 times higher among those with inner-ear problems who'd experienced dizziness or other symptoms.

The likelihood of inner-ear problems increased dramatically as people got older, with 85 percent of those over age 80 having these balance issues. Also, people with diabetes were 70 percent more likely to have inner-ear dysfunction. This is probably because high blood sugar levels can damage cells that aid balance control in the inner ear, as well as the inner ear's small blood vessels.

What you need to know. This study shows that inner-ear problems are extremely common, and closely tied to the risk of falls. These findings should alert doctors and older patients to be watchful for early signs of inner-ear problems and consider treatment.

Physical rehabilitation exercises may be an option for many, say the researchers. Studies show that these exercises can train the brain to compensate for inner-ear deficits and episodes of dizziness. In one exercise, for example, people stand on one leg, while lightly resting the other foot on a Styrofoam cup without crushing it. In another, people turn their head while walking. These are simple steps, but ones that may put you (or a loved one) on more solid footing.

—Sophie Ramsey, patient editor

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