Balance disorders in the elderly: what causes?

the elderly

The balance disorders in the elderly constitute one of the most frequent reasons for consultation in general medicine. Given its sometimes dramatic functional, physical and psychological repercussions, it is an important public health problem.

What are these problems due to? And what solutions can be envisaged for their care? Answer in this article.


Le balance disorder in the elderly represents an erroneous sensation giving the impression to the people feeling them that their body is moving relative to the space around them or vice versa. In other words, the person suffering from disorders of thebalanced feels drunk or walking on unstable ground.

This is a very common disorder in the elderly, felt more particularly during walking or standing and triggered by a sudden change of position or movement of the head.

Often associated and aggravated by other conditions affecting seniors such as cataracts, hearing loss orosteoporosis, this disorder is unfortunately often responsible for falls can have serious consequences and strongly impact the autonomy of the individual.

The balance disorders in the elderly may be accompanied by other symptoms such as tinnitus, nystagmus, a pallor, headache, nausea to vomiting.

Types of Balance Disorders in the Elderly

There are two types of balance disorders according to their origin:

  • Balance disorders of central origin, secondary to a lesion located in the cerebellum or brainstem. This lesion may be of a nature vascular, tumor, inflammatory ou infectious.
  • Balance disorders of peripheral origin, where the damage most often originates vestibular, whose main entities are the vertige benign paroxysmal positional, idiopathic vestibular neuronitis, Meniere's disease, acoustic neuroma and labyrinthitis.

How to diagnose balance disorders in the elderly?

The diagnosis of a balance disorder in a person is first done clinically thanks to:

  • A good interrogation making it possible to eliminate all situations of " faux dizziness», to determine the circumstances of onset and the risk factors and to look for the characteristics of vertigo (duration, intensity, mode of onset, associated symptoms, etc.).
  • Then comes the stage of the clinical examination which will include an ENT, vestibular, neurological, ophthalmological and general examination in search of an obvious cause of the onset of a balance disorder.
  • Finally, certain situations may require the use of complementary biological and imaging examinations as well as hearing tests in order to determine the origin and the exact cause.

Causes of Balance Disorders in the Elderly

The attack of one or more of the sensory receptors or a central attack are responsible for a balance dysfunction. And therefore, the main causes of a balance disorder in the elderly are:

  • Damage located in the inner ear, such as a trauma (fracture of the rock), a infectious attack bacterial or viral (otitic shingles), Meniere's disease, acoustic neuroma, a vestibular neuritis, otosclerosis, etc.
  • A decrease in visual acuity: caused by cataracts, macular degeneration or diabetic retinopathy.
  • A decrease in sensitivity of proprioceptive receptors due to ligament or muscle damage.
  • Lesions of central origin: can be vascular like a cerebellar infarction, inflammatory such as multiple sclerosis, tumorous especially posterior fossa tumors.

Finally, a balance disorder in the elderly may not be a vertige strictly speaking, but rather be the consequence of a discomfort secondary to other conditions, namely:

  • Orthostatic hypotension;
  • hypoglycemia;
  • A heart rhythm disorder;
  • An increase in cholesterol and triglycerides;
  • Anemia;
  • A cervical spondylosis ;
  • Taking ototoxic drugs and the various drug interactions;

Consequences of balance disorders

One of the main consequences of a balance disorder in people elderly is the fall and its complications that can be serious. In effect, fall in seniors constitutes the second cause of death after cardiovascular pathologies.

Falls pose a risk of femoral neck fractures and wrist, which is exacerbated by the presence of vitamin D and calcium deficiency. They also generate a significant Autonomy loss, a fear of going out causing isolation which represents a risk factor for psychic troubles see even trough.


Once the diagnosis of balance disorder retained and that its cause has been well identified, its management must be multidisciplinary and go through the intervention of different health specialists such as the general practitioner, the ENT, the neurologist, the ophthalmologist, the physiotherapist (physiotherapist) and the occupational therapist.

Treatment of the cause of balance disorder is obviously the first thing to do if possible. Thus, a vision disorder must be corrected, an infection or inflammation treated, hypoglycemia, anemia and vitamin deficiencies corrected, an adaptation of the treatments taken by the patient is also desirable.

In the case of benign paroxysmal positional vertigo or secondary to Ménière's disease, for example, anti-dizziness and antiemetics can be offered to relieve the patient.

Another important aspect of care is raising awareness about the practice of suitable physical activity. Sessions of physiotherapy (physiotherapy) can be proposed, if necessary.

Finally, we must not omit to support the dimension psychological and the impact that these disorders can have by remaining attentive to our seniors and by setting up a remote assistance system to reassure and support them.


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