By Anita Giles
MS, CCC-A Audiologist
Physicians Hearing Center
North Alabama ENT Associates
When we are born, we have limited abilities and over time, through learning we become a person with unlimited possibilities. Newborn babies come in to this world without knowing how to crawl, walk, run, or jump. They develop these skills through experience, practice, and repetition (facilitation). We are there to encourage, teach, and protect them.
Watching them grow and mature brings joy to us, especially if we are the grandparents. This process of growth and maturity happens when our senses send information to our brains for interpretation and it provides the needed instructions to hear, see, taste, touch, smell, and move. The brain learns to plan, focus, attend, remember, follow instructions, and multitask (cognition).
Over time, without much active thought we can walk, dance, stand, sit, run, play, see, and experience life. This happens because the brain is constantly working to keep the balance system functioning. There is constant communication happening from the top of your head to the tip of your toes.
Three body systems and your brain orchestrate the ability to balance and work together to keep stability of your body and vision.
Visual System: Your eyes provide detailed, colorful images of the world around you and a sense of the motion between you and your surroundings.
Auditory/Vestibular System: The inner ear balance organs inform the brain about the movement and position of the head, sensing up, down, backward, forward, and circular motion. Hearing provides spatial and timing information so movement can be calibrated. Hearing loss impairs cognition.
Proprioceptive: Special sensors sensitive to stretch or pressure in your muscles, joints, and tendons help your brain know how your feet and legs are positioned relative to the ground and your head to your chest and shoulders.
The Brain: The brainstem receives and sorts all the sensory information, consults with the cerebellum (coordination center) and cerebral cortex (thinking and memory) for input to apply to the current situation. Instructions are sent to the muscles of the eyes, head & neck, trunk & legs, to move in a way to maintain balance and focus vision.
There comes a time in life when walking, transitioning from pavement to grass, or getting out of bed at night without stumbling becomes difficult. Life has cycled to a time when you fall but don’t get back up. WHY? Balance system impairments result from injury, disease, medications, dementia, or the aging process. Medical conditions become more common as we age (arthritis, cardiovascular disease, diabetes, neuropathy, stroke, glaucoma, macular degeneration, cataracts, etc.). These conditions interrupt nerve impulse signals from the sensory receptors (eyes, ears, and proprioceptive) being sent to the brain, causing falls. Treatment of a variety of medical conditions with prescription medication may also contribute to this, as more than 2000 prescription drugs list dizziness as a side effect.
The goal is to maintain safety and the ability to live independently as you age. Left untreated, sensory impairments, including hearing loss, will cause the brain’s ability to manage your balance to decline. Help is available and possible as the balance system can reset or adapt to achieve a sense of balance again. No body part (eye, ear, foot, etc.) works alone and neither do we as humans. Your team includes your family/friend support system and professionals to evaluate, diagnose, develop, and implement a treatment plan. Otolaryngologists (ENT physicians), audiologists, and physical therapists frequently work with different dizziness, vertigo, and balance disorders. Treatment options may include hearing aids, physical therapy and balance exercises to help your body compensate and adapt.
Preventing falls and subsequent injuries should be a priority for all stages of life. Steps to improve safely moving and interacting within your environment may need to be implemented. These can include strengthening exercises, wearing proper shoes, improving lighting, using assistive devices (cane, walker, etc), and having all body systems that affect balance assessed (vision, auditory/vestibular and proprioception). Be aware and prepared.
September is Fall Awareness Month
Over 33% of the population 65 and older falls each year. Falls account for 25% of hospital admissions, 40% of nursing home admissions, #1 cause of fractures and the leading cause of accidental death in those over 65 years old.
Help prevent falls, reduce the risk of falls, and help older adults live without fear of falling.
Resources and References:
https://www.nia.nih.gov/health/falls-and-fractures-older-adults-causes-and-prevention
National Institute on Deafness and Other Communication Disorders (NIDCD): Balance Disorders
The American Institute of Balance;
Vestibular Disorders Association (VeDA)
https://www.ncoa.org/
https://www.apta.org/
https://www.asha.org
https://www.audiology.org
https://www.healthyhearing.com
https://hearingreview.com/inside-hearing/research/fall-risk-management-in-audiology-and-ent-practice-the-role-of-cognitive-vestibular-and-auditory-function
https://www.entandaudiologynews.com/features/audiology-features/post/a-multidisciplinary-approach-to-the-management-of-the-adult-balance-dizzy-patient
https://www.cdc.gov/falls/facts.html
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