Dizziness, vertigo or loss of balance?
What's the difference and what can you do about it?
Dizziness and vertigo are very common complaints among the elderly. However, feelings of unsteadiness are often dismissed and ignored because people think that they’re a normal part of ageing like (for example) loss of hearing. The good news is, they’re not a normal part of ageing! And can, in most cases, be improved. That means avoiding any negative effects and unpleasant feelings they can bring with them.
Dizziness and vertigo could be signs of underlying health conditions that should be examined by a doctor, although they can have their own repercussions. One of the main ones, especially among the elderly, is a fall. Falls can lead to serious physical and mental consequences which could diminish the quality of life of an older adult. Disability caused by fractures, breaks or head injuries could mean they have to change their lives completely, and their quality of life could be seriously affected. As well as physical effects, a fear of falling could lead to anxiety or the person limiting their activity so much they become isolated and even depressed. This doesn’t have to be the case. There could be an easy fix that could help you avoid the danger of falling almost completely.
What about loss of balance? That’s a leading cause of falls too. Unlike dizziness and vertigo, however, it is a normal part of ageing. But it doesn’t have to be. There are lots of things you can do to improve your balance.
Often, people use the three terms interchangeably, but if you’re interested in finding out the difference between the three, and what can be done about each one, you’re in the right place. Read on to find out what those differences are, so that if you do need to see a doctor, you can describe your symptoms accurately. This could make a difference when it comes to reaching a diagnosis of exactly what’s wrong.
Please do bear in mind that you should always consult your doctor to get advice if you’re worried or have any of the symptoms of dizziness or vertigo.
Loss of balance
Improving your balance could help you avoid falls in the future, and make sure that you stay on your feet for that much longer. One important thing we found out is that our balance starts to decline after the age of 35. We might not notice at first, but as we age we could start to feel really unsteady on our feet.
The good news is, we can work on our balance through specific exercises and improve it. Keeping active can only do good for both your brain and your body. Dancing, yoga, Pilates, and tai chi can help keep your balance on track, but even doing a few minutes of balance exercises per day could make a huge difference to your balance health. If you want to find out more about the specifics of loss of balance have a read of our article here.
Why does our sense of balance decrease with age?
As we age, our senses age with us. Just as our sight and hearing may start to worsen with age, so does our balance. Our sense of balance is mostly controlled by our vestibular system, which is made up of the cochlea and the labyrinth of our inner ear. Specialised nerve endings in our inner ear detect the position of our head and the direction of gravity. These nerve endings send signals to the nervous system and are important in helping the brain control balance.
As we age, the number of nerve endings decreases, as does blood flow to the inner ear. This means fewer signals are sent to the brain and can result in severe balance problems (Shupert, p.2).
Image source: the inner ear
By doing exercises to help improve your balance, you:
- keep your joints healthy by moving them regularly
- work on your core, strengthening the muscles that help keep you upright
- strengthen you’re the muscles around your joints, taking pressure off the joints
- keep your brain working, making new connections which means cognitive gains
You can’t undo the deterioration, but you can go a long way to countering it!
Dizziness is difficult to define because it means different things to different people. The first thing we told you is that dizziness is not a normal part of ageing, so you should definitely pay attention to it.
People might go to a doctor complaining of dizziness, and mean:
- the room is spinning
‘To be alive is to be dizzy and not to know exactly where to go’
The room spinning is a specific type of dizziness – vertigo – so getting this distinction right is important. These are all very different sensations, so understandably the doctor might have trouble knowing exactly what’s wrong. They’ll probably ask for a medical history, and have to look into lots of different reasons for dizziness to find out what’s causing your discomfort.
If you’re feeling dizzy it could be:
- a side effect of any medication you might be taking (it’s always worth reading the label if you think that’s a possibility)
- sign of a vestibular disorder (a dysfunction of the balance organs of the inner ear or of one or more parts of the central nervous system). Vestibular disorders are often treatable. (King, Buckner, p.1).
The good news is, we’re here to differentiate those feelings for you. However, often a combination of factors can affect your balance, and it might be a case of testing for everything to determine the cause of your dizziness.
If you are feeling dizzy sit or lie down, that way you can avoid falling and the possibility of it resulting in serious injury.
What causes light-headedness?
Light-headedness is a “woozy” feeling or feeling that you might faint. Although you may feel it when you stand up quickly, it usually passes after a few seconds.
There are many possible causes for light-headedness. It could be caused by:
- low blood sugar
- visual impairment
- difficulty balancing
- side effects of your medication
- hyperventilation (for example before or during a panic attack)
Loss or deterioration of sight or hearing can be linked to loss of balance, and a doctor can check for all of these. If your eyes and / or ears aren’t sending the correct sensory information to your brain, you can feel quite disorientated. (Eggenberger, p.1)
If your light-headedness persists, it could be worth seeing your doctor.
What causes faintness?
Feeling like you’re going to faint also isn’t a side effect of ageing. Often people will feel faint when they stand up quickly, or when you sit up after you’ve been lying down. If this is the case for you, it’s a good idea to do those things very slowly, to try to stop yourself from falling.
Feeling faint could be a side effect of medication you’re taking, but could also be a sign of:
- a thyroid problem
- an arrhythmia (an irregular or abnormal heartbeat)
If the feeling of faintness persists, it’s a good idea to see your doctor to make sure it’s none of the more serious possibilities.
What causes dizziness in general?
There are many possible causes for dizziness. It could signify the presence of a vestibular dysfunction along with another problem, which could be:
- with your vision
(King, Buckner, p.1).
It may be that the combination of problems is what is affecting your balance so dramatically, and it could mean the source of your dizziness is not easy to find. It is worth trying to find the source though, as there could be a cure for your dizziness.
‘I have vertigo. Vertigo makes it feel like the floor is pitching up and down. Things seem to be spinning. It’s like standing on the deck of a ship in really high seas.’
Often people describe vertigo as dizziness. It is a type of dizziness, but it’s a very specific type. The difference between vertigo and dizziness is that vertigo, specifically, makes you feel as if you or the room around you is spinning.
Vertigo can last anything from seconds to days, and mostly happens when you move your head.
What causes Vertigo?
Vertigo could indicate a vestibular dysfunction, in other words; something is the matter with the balance organs of your inner ear.
The most common cause of vertigo is benign positional paroxysmal vertigo (BPPV). This is not serious, but can cause some discomfort. It’s caused when debris dislodges itself and is either free to move about, or collects on a bundle of nerves in the inner ear. When the debris is free, it moves when you move your head, sending false signals to your brain and causing vertigo. This condition is more common among the elderly as it can be caused by inner-ear hair cells degrading.
The good news is, BPPV can be treated. The treatment is mechanical. It uses gravity to move the debris back to where it should be by moving your head in specific ways, depending where the debris is, and if it’s lodged somewhere or free-moving.
Apart from giving you vertigo, BPPV shouldn’t affect your hearing or give you any other serious symptoms so if you are experiencing other unusual sensations it’s probably best you see a doctor.
More serious conditions
Although vertigo could have an easy fix, it’s important to remember that it could also be linked to more serious conditions. These are much less likely to be the cause of your room spinning but if you have additional symptoms consider these possibilities:
- Head injuries
- Meniere’s disease. Large amounts of fluid collect in the inner ear and cause symptoms that differ from person to person. It may start with fluctuating hearing loss and could lead to attacks of vertigo and dizziness. Sufferers of Meniere’s disease often say their ear feels full, or they might have tinnitus. This disease is incurable but there are medications to help manage the symptoms.
- Labyrinthitis is an infection of the inner ear. It causes an inflammation which disrupts the signals going from your inner ear to your brain. It can cause vertigo, dizziness and difficulties with balance, vision or hearing. Again, medication and self-help can lessen the effect or even cure labyrinthitis.
A fear of heights
Vertigo is often associated with a fear of heights, but in reality, these are very different things.
A fear of heights is an interesting fear, as unlike most other fears, it increases as we age, rather than decreases. There are two possible reasons for this increase. Psychology today states that it has to do with our sense of vision. We maintain our balance by focusing on objects that are within 30 feet, by using the objects as a reference. As we look out from a high viewpoint, our eyes can’t find this object, so focus and un-focus, making us feel disorientated and possibly throws our balance off. But this doesn’t answer why this gets worse as we age.
‘Vertigo is the conflict between the fear of falling and the desire to fall.’
Health central suggests a different reason. They suggest that a fear of heights could stem partially from our deteriorating sense of balance, but could also be linked to increased worry of falling. Older adults often have people who depend on them, meaning that if they fell, it would negatively affect the people around them. This heightened awareness of the repercussions of a fall could lead to a heightened fear of the fall, and therefore of heights.
“From the vertigo, I found out how far I can push myself physically and also mentally.”
We don’t know which idea is most accurate, although it could well be a combination of the two. When it comes to phobias, one way of dealing with them is to face them, exposing ourselves to them in short bursts. This allows us to see how our fear is sometimes unfounded, and that we are safe after all. That said, our balance doesn’t function well when we are anxious, so if you do plan on overcoming your fear, do so with caution and maybe with help from a loved one.
- Eggenberger, E. Lovell, K. Vertigo and Dizziness; Vestibular System Disorders – Summary. Michigan State University. Retrieved from: http://learn.chm.msu.edu/NeuroEd/neurobiology_disease/content/otheresources/vestibulardisorders.pdf
- King, J. Buckner, S. Causes of Dizziness. Vestibular Disorders Association. Retrieved from: https://vestibular.org/sites/default/files/page_files/Documents/Causes%20of%20Dizziness.pdf
- Shupert, C. Balance and Ageing. Vestibular Disorders Association. Retrieved from: http://vestibular.org/sites/default/files/page_files/Balance%20and%20Ageing_0.pdf