Dizziness and balance issues can become a problem at any age, but they are more common in adults over age 65. Often, aging and other medical conditions that are more common in older adults, such as diabetes and peripheral neuropathy, can impact the ability to maintain balance.
The body has three primary sensory systems that work together to create postural stability and normal balance. With normal brain function, the vestibular system of the inner ear coordinates with the visual system and proprioceptors that sense the position and movement of your body in space. These three systems work together while we perform simple tasks, such as standing and walking, or more complex and dynamic activities, such as yoga or hitting a golf ball accurately. If there is something wrong with one of these systems, it can affect the body’s ability to maintain proper balance.
Some medical conditions that may impact balance, and which are more common in older adults include:
- Impaired Inner Ear Function
- Cardiovascular Health
- Neurological Disease
- Arthritis
- Mental Status
- Nutrition
- Impaired Vision
- Lifestyle and Environmental Factors
Impaired inner ear function is one of the most common conditions responsible for problems with balance, and often is identified as benign paroxysmal positional vertigo, or BPPV, the most common cause of vertigo. In fact, this condition affects approximately 50 percent of individuals over 70 years of age at least once in their lives.
BPPV is caused by small calcium carbonate particles (otoconia), which are normally found in the inner ear. These particles can become displaced and migrate into one of the ear’s semi-circular canals, where they do not belong. This condition is characterized by brief and intense episodes of vertigo that occur with a change in position. BPPV may be the result of the natural aging process, illness, a change in medication, or head trauma. Often, no known cause for BPPV can be identified.
Diagnosing BPPV
A vestibular evaluation is the gold standard for diagnosing dizziness and balance disorders, including BPPV. Comprehensive testing of the outer, middle and inner ears should be performed. These tests include audiologic, tympanometry/immittance and otoacoustic emission tests.
Other sophisticated measures include these tests:
- Auditory Brainstem response
- Computerized Dynamic Visual Acuity (CD-VAT)
- Electro-oculography
- Electrocochleography (ECOG)
- Rotary Chair
- Sensory Organization Performance
- Vestibular Evoked Myogenic Potential
- Video-nystagmography
- Video head Impulse Test (vHIT)
Treating BPPV
The most popular treatment for BPPV is a simple and painless repositioning maneuver. The treatment returns the otolithic debris to its originating larger space within the ear (utricle), allowing the body to absorb the calcium particles within several hours to days.
The repositioning maneuver is not a permanent cure, but instead a treatment. At Associated Audiologists, results in treating patients with BPPV have been very successful. We have found that 80 percent of patients need one treatment, 17 percent will need two, and only 3 percent will need three or more.
Specializing in Vestibular Audiology
Danielle Dorner, Au.D., C.C.C.-A., vestibular audiologist with Associated Audiologists, is a specialist diagnosing and treating patients with dizziness and balance disorders.
Dr. Dorner joined Associated Audiologists after performing her clinical externship with the practice. She earned her doctorate of audiology degree from Northern Illinois University and her bachelor’s degree from Augustana College, Rock Island, Illinois.
She is a member of the Academy of Doctors of Audiology (ADA), holds a certificate of clinical competence (C.C.C.-A.) from the American Speech-Language-Hearing Association (ASHA), has earned her CAOHC certification from the Council for Accreditation of Occupational Hearing Conservation, and is a member of the Kansas Speech-Language-Hearing Association (KSHA).
Dr. Dorner practices at our Northland and Overland Park clinics. Schedule an appointment.
