Why Do The Elderly Fall? The Brain, Not Just The Body, Holds The Answer

When one talks about the brain, our focus is usually on memory, creativity, and mental health, and ‘balance’ is overlooked. The brain helps in maintaining this balance and prevents us from hitting the floor. For the young, balance is automatic; for the elderly, it becomes a complex cognitive task. 

Disbalance in elderly people can lead to falls, which are sometimes life-threatening. Fractures, hospitalization, long-term disability, and sometimes death may be caused by falls.

Process of ageing and falls 

The brain coordinates with the inner ear, eyes, muscles, and joints, and integrates these signals to maintain posture and balance. This coordination becomes less efficient as we age. Ageing causes a decline in vision, reduced sensitivity to motion and head movements, and loss of muscle strength and flexibility. The brain works harder in elderly people to interpret these signals, as it sometimes receives delayed or incomplete information, which can lead to falls. In the majority of cases, falls are not a musculoskeletal issue; rather, they are caused by miscommunication between the brain and the inner ear.

Falls: A silent threat to longevity 

Around one in four adults aged 65 years or older falls annually, with a prevalence of 25 per cent in the 60-69 years age bracket and over 40 per cent in the population aged 80 years or older. The comorbidities caused by falls include hip fractures and traumatic brain injuries, which further elevate the risk of mortality.

Globally, falls are the second leading cause of unintentional injury deaths, contributing to nearly 40% fall related mortality every year. Even a single fall can cause a permanent fear in an elderly person’s mind. Nearly 30% of elderly people restrict activity due to fear of falling. This fear causes the brain to stiffen the muscles and shorten the walking stride, which can alter normal walking patterns.

Benign paroxysmal positional vertigo in the elderly

Balance problems are often mistaken as a normal part of aging, and the age-related decline of the balance system is often overlooked. One such condition is BPPV, in which tiny crystals become dislodged from one part of the inner ear into the semicircular canals, causing brief episodes of vertigo. Many elderly people suffer from Benign Paroxysmal Positional Vertigo (BPPV), which increases the incidence of falls, especially in poorly-lit and unfamiliar environments. 

Protecting the balance as the brain ages 

As the Brain ages, protecting balance becomes essential in maintaining independence and quality of life. 

Fall risk assessment: The first step towards preventing falls is to undergo a fall risk assessment at specialized centers for dizziness. It helps identify individuals at higher risk of falls early, thereby preventing injuries and reducing mortality.

Balance exercises: Yoga, Tai Chi, and balance-focused physiotherapy help strengthen the body and brain, thereby improving posture and maintaining stability.

Training brain and body together: A combination of balance activities with simple mental tasks, such as walking while counting backwards, helps the brain coordinate movements more smoothly and improves overall stability.

Our brain has an impressive ability to adapt even as we grow old. Maintaining balance is a skill that requires regular practice. 

Brain Awareness Week reminds us of the crucial role of the brain in maintaining balance and preventing falls, especially in the elderly people. If you or your loved ones experience persistent dizziness, imbalance, or frequent falls, seek evaluation at a nearby vertigo and balance clinic to ensure timely care.

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