Loss of balance has always been associated with the elderly but research suggests it’s happening more and more among younger people
When did you last fall over? It’s something we associate with the sunset years, but experts are warning the fall rate is rising sharply among midlifers, with increasingly sedentary lifestyles making us less steady on our feet.
Balance begins to decline from the age of 30, and from the age of 50 we become more vulnerable to falling, says Professor Dawn Skelton of Glasgow Caledonian University.
“Of course we all fall throughout our lives, but the problems come when we start to fall when we shouldn’t and more importantly we’re seeking medical attention as a result.
“Falls used to start to be a problem at age 65, but in the last 20 years we’ve seen that creep earlier and earlier, and now more people in their late 40s and early 50s are seeking medical help because of falls.”
Research suggests the fall rate in the 40-plus age group is up by as much as 20 per cent on the previous generation. One American study found fatal falls are rising sharply for those aged between 45 and 64, jumping by 44 per cent between 1999 and 2007.
We’re seeing more serious injuries as a result, says Prof Skelton.
“People are starting to fall and break their wrists in their 40s when it used to be the 60s. It used to be that hips started breaking at 75/80 but now, in certain deprived areas of Glasgow, we are seeing hip fractures in the late 50s.”
Experts believe that the fault lies in our increasingly sedentary lifestyles, with problems being set up in childhood.
“Sport has become an optional extra rather than something that’s embedded in our school life. There’s also a big difference in activity outside school. When I was young you’d come in from school, dump your bag and go out. Now it’s more common to sit on devices,” says Prof Skelton.
“Balance is something we learn unconsciously when we’re young, so this decline in activity means we’re not building good nervous system integration. It’s also the time we lay down bone density and so that might be why we’re fracturing earlier.”
Rising levels of obesity are also thought to be behind the trend – being overweight affects stability and balance. Diabetes is inked with a higher risk of falling, because the condition causes reduced sensations of the extremities, according to research by Dr Geeske Peeters at the Global Brain Health Institute. Dr Peeters says falls prevention programmes should start earlier before issues take hold.
If you’re prone to car sickness, or feel dizzy if you turn your head too quickly, this can mean you’ll be more prone to balance issues.
An unexplained or unexpected fall is a clear warning sign your stability is decreasing. “If you have a couple of falls where you think ‘how did that happen?’ you need to work on your balance,’” says Prof Skelton.
Rather than waiting for an accident, an easy way to check your balance skills is to time how long you can stand on one leg.
Up to the age of 50, you should be able to manage one minute with your eyes open, or 12 seconds with your eyes closed, says Prof Skelton. Try this next to a wall or in a doorframe in case you need to steady yourself.
Between the age of 50 and 60 you should be able to manage 30 seconds with your eyes open and six seconds with them closed. (Don’t be shocked if you can’t do it, says Prof Skelton – most people can’t, but you’ll improve within a few weeks if you practice.)
Balance uses three types of sensory input, she explains. Firstly, visual information about our surroundings and where we are in relation to them, secondly signals from sensors in the joints, in the ankles, hips and knees, known as proprioceptors, and finally the signals from the semi-circular, fluid-filled canals of the inner ears, known as the vestibular system.
“The brain has to coordinate all that information and decide what to do with it, for example put my hand out quickly to grab hold of something, or take a compensatory step, or lean back,” says Prof Skelton. “All these things are unconscious but the more sedentary you are, the less these are going to kick in when they need to.
“If you are sedentary, and therefore weaker, you might not get your foot out quickly enough to prevent a fall. Or if the vestibular system is stodgy, the information feeding into the brain won’t be as quick or accurate.”
Physical inactivity, for example through a stay in hospital or prolonged sitting, can cause a catastrophic loss of strength and balance, especially in older adults.
“You lose about 10 per cent of your strength for every day that you are in hospital,” says Prof Skelton. “Anyone who sits for more than eight hours a day is at 30 to 50 per cent greater risk of frailty later on in their life, which comes with falls and balance problems.”
It’s highly likely, then, that many Britons, stuck at home during this year’s lockdowns, are now at a higher risk of falls.
The good news is that you can retrain your balance “muscle” quite quickly – though lost bone density is harder to recoup.
We usually cope with poor balance by avoiding wobbly activities, but it’s better to keep challenging yourself as this is the only way it will improve, she says.
“If you can’t do the 30-second balance exercise, or the exercise with your eyes closed, you actually just need to just get out there and do as many twirling, swirling balance exercises as possible.”
Seven ways to get your balance back
- Every time you make a cup of tea, use this as a cue to stand on one leg, standing well away from the kettle. Use the tips of your fingers for balance, if you need to initially, but work towards taking your hand away. Balance on your left leg for 30 seconds, then change legs. Repeat twice on each leg. Now repeat the exercise with your eyes closed. It’s normal for one side to be easier than the other, though you should work on training out any asymmetry.
- Stand up hourly. Practice chair squats: stand up then sit down again without using the armrests. Repeat fifteen times.
- Walk up and down stairs without holding onto the handrail.
- Strengthen your feet. Practice standing on tiptoes. Alternate this with lifting your toes and balancing on your heels. Most of us will initially wobble, on our heels, but you’ll get better with practice. Going barefoot at home can significantly improve your balance, unless you already have a balance problem – in which case keep your shoes on as going barefoot will increase chances of a fall.
- Practice walking sideways, crossing your feet.
- If you suffer from dizziness when turning fast try some gaze stability exercises – there are hundreds to try on YouTube.
- Sport like tennis and squash, with lots of quick turns, are great for balance – or just hit a ball against a wall. Dancing is great too (solo is better than with a partner), the more frantic the better – or go rambling over uneven ground.