Inner Ear Dysfunction Puts Older Adults at Risk of Falls   

After 40, dizziness makes them 12 times more likely to suffer serious injury, study finds  

Falling is a major concern of many people of advanced age (>75 years).  One of the greatest predictors of falls in the elderly is a previous fall.  So logic would have us discover how to go about preventing that first fall.  

Clinical experience has taught us that it’s not the fall that kills someone.  It’s the cascade of events that occurs after the fall that insidiously leads to a person’s demise.  A fall can lead to a fracture, a hospital stay, an infection in the hospital, adverse response to treatment, deconditioning, further falls, fear of being active, etc.  The cycle persists as a person declines. 

However, the new research out of Johns Hopkins University sheds light on a possible doorway to stop this pathway for many people.  

The numbers. 

About 69 million Americans over age 40 have some form of inner-ear dysfunction that causes dizziness and makes them up to 12 times more likely to suffer a serious fall, a new survey shows. 

More than 22 million of those people are unaware of their risk, mostly because they've had no previous incidents of dizziness or sudden falls.  This was indicated by the Johns Hopkins researchers who surveyed more than 5,000 men and women over age 40. 

Compared to people with a healthy sense of balance, those with an inner-ear dysfunction who had experienced no symptoms were three times more likely to suffer a potentially fatal fall than other people, while those who'd experienced symptoms had a 12-fold greater risk for falls in general, the study authors concluded. 

Woe to thee over eighty and to those who fail to regulate their sugar. 

The survey found that 85 percent of respondents over age 80 had a balance problem -- a rate 23 times higher than those in their 40s. People with diabetes were 70 percent more likely to have balance problems than those without the disease, according to the study. 

"Vestibular imbalances need to be taken seriously, because falls can be fatal and injuries can be painful, lead to long hospital stays and result in significant loss in quality of life," Dr. Lloyd B. Minor, a professor and director of otolaryngology-head and neck surgery at Johns Hopkins University School of Medicine, said in a Johns Hopkins news release. 

Accidental falls are a leading cause of death and injury among the elderly. Each year in the United States, falls kill about 13,000 seniors and result in more than 1.5 million visits to hospital emergency departments, the release noted. 

"Our survey shows that balance testing needs to be part of basic primary care, and that all physicians need to be monitoring and screening their patients for vestibular dysfunction so that we can take preventive measures to guard against falling," Minor said. 

Rocks in Your Head! 

The inner ear has canals which help send messages to the brain about body position/orientation in space that can get filled with small crystals of calcium carbonate called canalith.  The canalith can get lodged in one of the canals sending phony messages to the brain, causing feelings of unsteadiness, dizziness, or even vertigo.  This syndrome is called benign paroxysmal positional vertigo (BPPV). 

The problem usually resolves on its own in 4 weeks time or can be treated with simple repositioning exercises that are known by a doctor, therapist, or audiologist.  Once administered and positioning/posture guidelines are known, then the dizziness usually abates completely within a couple of days.  

An Ounce of Prevention. 

While many things can cause dizziness (weak heart, circulation, blood pressure problems, and others) often times the benign inner ear it is one symptom that should be addressed by a physician or health care provider quickly.   

Researchers are advocating dizziness and balance screening to be part of a routine physical evaluation done by medical practitioners for all persons of advancing age, or whose risk factors predispose them to falls.