BALANCE
Balance issues commonly occur with aging due to a combination of physiological changes, neurological decline, and environmental factors. As people age, several systems that contribute to maintaining balance can deteriorate, making older adults more susceptible to balance problems and falls. Here are some of the primary reasons why balance issues increase with aging:
1. Degeneration of the Vestibular System and Cerebellum.
The vestibular system in the inner ear is essential for maintaining balance by detecting changes in head position and motion. With age, the hair cells in the vestibular system gradually degenerate, leading to a decrease in vestibular function. This decline can cause dizziness, vertigo, and an increased risk of losing balance. The cerebellum is a part of the brain that controls balance and motor coordination. For various reasons, it can degenerate, causing a wide stance gait and or swaying to one side. There is a pathway in the brain called the vestibulo-cerebellum. This is the main pathway that controls balance and coordination with our visual and somatosensory systems. Interestingly, the vestibulo-cerebellum dysfunction will also cause anxiety and tight neck and back muscles.
2. Muscle Weakness and Reduced Flexibility
Muscle mass and strength naturally decrease with age, a condition known as sarcopenia. Weakness in the core and lower extremities, in particular, can affect stability and balance. Additionally, reduced flexibility and joint mobility make it more difficult for older adults to react quickly and maintain their balance, especially when navigating uneven terrain or recovering from a trip or slip.
3. Decreased Proprioception
Proprioception is the body’s ability to sense its position in space. With aging, there is a decline in the function of proprioceptive receptors located in the muscles, tendons, and joints. This decline can make it more difficult for older adults to sense their body’s movements and positions, thereby impairing their ability to maintain balance.
4. Changes in Vision
Vision plays a critical role in maintaining balance by providing the brain with information about the body’s position relative to the environment. Age-related changes in vision, such as cataracts, macular degeneration, and reduced depth perception, can affect spatial orientation and make it harder to maintain balance.
5. Cognitive Decline
Cognitive functions, including attention, reaction time, and executive function, tend to decline with age. Cognitive impairments can interfere with an older adult’s ability to process sensory information (visual, vestibular, proprioceptive) quickly and accurately, leading to a decreased ability to maintain balance, especially in complex environments or situations that require rapid decision-making.
6. Slower Reflexes
Aging is associated with a natural slowing of reflexes and reaction times. This slower response can make it more challenging for older adults to quickly adjust their posture when they encounter a potential balance challenge, increasing the risk of falls.
7. Medical Conditions and Medications
Many older adults suffer from chronic conditions such as arthritis, neuropathy (nerve damage), diabetes, or cardiovascular disease, which can directly or indirectly affect balance. Additionally, medications commonly prescribed to older adults (e.g., sedatives, antihypertensives, antidepressants) can have side effects that include dizziness, drowsiness, or impaired coordination, further increasing the risk of balance problems.
8. Reduced Physical Activity
Many older adults become less physically active over time, leading to further deterioration in muscle strength, flexibility, and cardiovascular fitness. A sedentary lifestyle can exacerbate age-related declines in balance and increase the risk of falls.
9. Environmental Factors
Environmental hazards, such as poor lighting, slippery floors, loose rugs, or uneven surfaces, can pose a greater risk for older adults who already have compromised balance. These factors, combined with decreased sensory input and physical capabilities, increase the likelihood of falls.
OUR APPROACH:
Of course every patient is different so it is important to focus on the factors above and begin to correct them. We utilize Functional Neurology to assess the patient and provide specific brain based exercises targeted to restore their balance. These are the most common strategies we use:
Vestibular Rehabilitation: This involves exercises that specifically target the vestibular system in the inner ear, which is crucial for maintaining balance. Techniques might include gaze stabilization exercises, balance retraining, and habituation exercises, all aimed at improving the brain’s ability to process balance-related sensory information.
Eye Movement Exercises: Eye movements are closely linked with balance and spatial orientation. Exercises that train the brain to coordinate eye movements (like saccades and smooth pursuit exercises) can enhance vestibular function and improve balance.
Postural Training: Techniques like proprioceptive training (improving awareness of body position in space) and strengthening postural muscles can help improve stability and prevent falls.
Neuroplasticity-Based Interventions: Functional Neurology often involves exercises designed to promote neuroplasticity, the brain’s ability to reorganize itself by forming new neural connections. These exercises are tailored to the individual’s specific deficits and aim to retrain the brain areas involved in balance.
Nutritional Support: Certain nutritional deficiencies (e.g., vitamin B12, vitamin D, magnesium) can contribute to neurological dysfunction, including balance problems. Functional Medicine practitioners may recommend dietary changes or supplements to correct these deficiencies and support overall neurological health.
Inflammation Reduction: Chronic inflammation can impair brain function, including the areas involved in balance. Functional Medicine may focus on identifying and reducing sources of inflammation, such as food sensitivities, chronic infections, or environmental toxins.
Hormonal Balance: Hormones like cortisol and thyroid hormones play a role in brain function. Functional Medicine may involve balancing hormones through lifestyle interventions, supplements, or medications, which can help improve neurological function and balance.
Detoxification: Exposure to toxins (like heavy metals) can impair neurological function. Functional Medicine may involve detoxification protocols to help the body eliminate these toxins, potentially improving balance and other neurological functions.
Common Approaches in Both DisciplinesBoth Functional Neurology and Functional Medicine often emphasize the importance of a holistic approach to health, incorporating lifestyle modifications, stress management techniques, and personalized treatment plans that address the individual’s unique needs. By combining neurological rehabilitation strategies with a functional approach to health and wellness, these disciplines aim to improve balance and overall quality of life.
Conclusion
Functional Neurology and Functional Medicine can provide a synergistic approach to treating balance issues by focusing on both the neurological aspects and the underlying systemic health factors. This comprehensive strategy can lead to more effective management and potentially better outcomes for patients experiencing balance difficulties.