Keeping our balance

My dad, a sturdy farm boy who ran cross country and played baseball in high school, ended up in a job that kept him in good physical shape for most of his adult life. For more than 30 years, he walked several miles a day delivering mail on his route in Baltimore that included hilly residential streets and businesses along a major thoroughfare.

He lived to 92, but in his later years, he often had trouble keeping his balance. I don’t mean his mind; his thinking was sharp until the end. I mean his physical balance.  Increasingly he would stumble or lurch, often reaching to grasp a stable object to regain his balance. He joked about his gyroscope being out of whack. His diagnosis wasn’t far off, it turns out.

Experts tell us that our sense of balance depends on a series of signals to the brain from several organs and structures in the body, known as the vestibular system. It all begins with a structure in our inner ear called the labyrinth. Canals in the labyrinth contain  fluid-filled ducts, which tell our brain when our head turns or moves up or down. Inside each canal a structure called the cupula sits on a cluster of sensory hair cells. When we turn our head, fluid inside the canal moves, causing the cupula to flex, which bends the hair cells, and this sends a signal to the brain to tell it which way our head has turned.

When we move, the vestibular system detects mechanical forces, including gravity, that stimulate these canals and other organs, which work with other sensory systems in our body, such as  vision and musculoskeletal sensory system, to control our position. This helps us maintain stable posture and keep our balance when we’re walking or running. It also helps us keep a visual focus on objects when our body changes position.

When any of the signals from any of these sensory systems malfunctions, we can have problems with our sense of balance. If we also have problems with motor control, such as weakness, slowness, tremor, or rigidity, we can lose our ability to recover our balance. This increases the risk of a fall. About 9 percent of older adults report experiencing balance problems. It’s a major reason so many seniors fall. The Centers for Disease Control and Prevention report that more than one-third of adults ages 65 years and older fall each year. Among older adults, falls are the leading cause of injury deaths.

Ear infections, high blood pressure, side effects of medications, lack of activity, all can contribute to our sense of losing our balance, and as we know, most of these triggers are common among us older adults.

Our twice-a-week exercise class for older adults at the local Y often concludes with a few balance tests. We all try to maintain our balance while standing one one foot, extending the other leg out to the side, in front or behind us for several seconds, or we try to walk a straight line, placing one foot directly in front of the other, both forward and back, as a police officer would do when checking a driver for alcohol impairment. Yes, we all tilt, flap our arms and stumble a bit, and we laugh at ourselves, but by and large, we’re doing a fair job of keeping our balance, so far.

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