Tips for the Elderly: Falling Down vs. Staying Steady

For the aging, balance can become a big issue. Here’s why.

Senior woman with trainer

Maintaining your balance is a key to remaining independent. A physical therapist can guide you to a fitness program that works with your lifestyle and strength level.

© Ammentorp |

Balance is defined as the ability to maintain the body’s center of mass over its base of support. This is achieved by a complex interplay of input to the brain from our eyes, our muscles and joints, and the vestibular organs in our inner ear.

Even in the absence of other medical conditions, our risk of developing balance problems—and the potential for elderly falling-down accidents—increases with age.

A variety of health-related reasons can come into play in compromising our balance:

  • Cells in the vestibular system begin to die off
  • Our vision diminishes
  • Hearing deteriorates
  • Muscle mass and strength deteriorate
  • Reflexes slow

Health Conditions That Can Affect Balance

Many different health conditions can impact our balance and result in the elderly falling down:

  • Eye disorders: As vision is an important part of the sensory input that helps us maintain balance, conditions that affect our eyes can impact balance. Eye muscle imbalance, cataracts, macular degeneration, and diabetic retinopathy are examples of such conditions.
  • Arthritis: The pain and the limitations on range of motion that arthritis can cause in our joints can impact our ability to maintain our center of gravity over a stable base of support. Arthritis can cause changes in posture that impact balance as well.
  • Nerve problems: The nerves in our feet and legs tell our brain where these body parts are and provide them with the signal from our brain to move. Many diseases can affect these nerves, and thus our balance; among them are multiple sclerosis, Parkinson’s disease, stroke, and diabetes.
  • Diabetes: In addition to affecting the nerves in our feet and legs, diabetic neuropathy can affect the nerves in our autonomic nervous system that help us stay steady as we go from lying down to standing. Diabetes can also affect our vision and increase the risk of stroke. Low blood sugar levels can also undermine our balance, causing lightheadedness or weakness.
  • Ear disorders: The inner ear is a critical part of maintaining balance. Localized ear infections, upper respiratory infections or vertigo can all affect the vestibular system of the inner ear and, thus, our balance.
  • Dehydration: Dehydration can affect our ability to tolerate changes in posture.
  • Side effects from medications: Many different medications can impact our balance. Examples include blood-pressure-lowering drugs (including diuretics and ace inhibitors), some antibiotics, chemotherapeutic drugs, antihistamines, and sleep aids, among others. Additionally, the interaction of different medications can affect balance.

Diagnosing and Treating Balance Problems

If you are experiencing problems with your balance, you should consult your healthcare provider. If your balance problem is related to an underlying medical condition, identification and treatment of that condition may improve your balance.

If you have not already been diagnosed with an underlying condition, physical examination can often determine whether the problem is musculoskeletal, neurologic, or vestibular. Your primary healthcare provider may refer you to an ears, nose, and throat (ENT) doctor if they suspect the cause is related to your vestibular system.

There are several different problems that can affect the vestibular organs in the inner ear. In the elderly, the most common of these is benign paroxysmal positional vertigo, in which calcium particles build up in the canals of the inner ear.

Treatment usually involves physical maneuvers that make use of gravity to get the particles dislodged from the canals.

Tips on Improving Your Balance

The ability to maintain balance is key to preventing falls that lead to fractures and head injuries. Here are the basics—routines that can help improve any senior’s balance and prevent elderly falling-down accidents:

  • Balancing exercises for seniors: In addition to regular aerobic and muscle-strengthening exercises, there are specific balance exercises you can practice. If you have underlying medical conditions, you should consult your healthcare provider before beginning balance exercises. He or she may refer you to a physical therapist who can create a regimen best suited to your needs.
  • Assistance devices: If you suffer from a medical condition that affects your balance such as arthritis or Parkinson’s disease, or if you have suffered a stroke, you may need to use a cane or walker to help you maintain your balance. Medical supply stores carry these and can help you find one that fits your body and your needs.

Originally published in February 2016 and updated.

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Helen Boehm Johnson, MD

Helen Boehm Johnson, MD, is a medical writer who brings the experience of a residency-trained physician to her writing. She has written Massachusetts General Hospital’s Combating Memory Loss report (2019, 2020, … Read More

View all posts by Helen Boehm Johnson, MD

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