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Mid Coast Center for Community Health & Wellness Newsletter
January 2019
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Balance and the Aging Brain


Balance issues are common as we age for a variety of reasons. Since we stand on two limbs, walking is an act of throwing ourselves forward in a form of controlled falling, though with practice early in life, we eventually develop a confident sense of unbroken motion.

But that skill is governed by a very complex system. Our eyes are a direct extension of the brain and give the parietal lobes a visual map of the three-dimensional space around us, enabling the brain to place us in the center of things. Our inner ears contain semicircular canals in which fluid-filled spaces lined with tiny hair cells react to gravity and sense the direction our heads move–a sort of gyroscope function. That information is fed to the brainstem.

Tiny nerves in the feet, joints, and spine send signals to the spinal cord about where they are in space - the so-called "proprioceptive sense." The posterior column climbs to the brainstem, and fibers from all of these inputs converge on the cerebellum, which sits in the back of the brain and is the home of balance in our nervous systems. The cerebellum can react reflexively to challenges, such as stumbling, without involving the conscious mind, or the "you" in you.

Unfortunately, when one has a problem with any of these components, balance may suffer. Consider the loss of sight, numbness in the feet, or damage to the inner ear. Each of these influence balance. If only one sense is affected, a person might be able to compensate. For example, if a person has numb feet, they can compensate by using the inner ears and by keeping their eyes on where their feet are going. If that same person walks through a dark room, or closes their eyes in the shower, they might lose balance and fall.

The parts of the brain that integrate the senses may have problems too. Stroke, dementia, and other brain diseases may affect balance. Consider the case of the basal ganglia. This deep brain structure rests far back behind your eyes, and like the hard drive on a computer, contains cells which store patterns of movement learned over a lifetime, such as walking, riding a bike, typing, playing the piano, hand gestures, and so on. The basal ganglia requires dopamine, and when that runs low, such as when a person has Parkinson's Disease, balance, gait, and postural reflexes can be affected.

The brain itself tends to lose a little volume as we age, and with that volume, function. One of the most affected areas is the cerebellum, especially the part that corresponds to the legs and trunk–bad news for elderly tightrope walkers.

Finally, loss of flexibility and problems with joints may also lead to difficulty with the complex movements and postures needed to maintain balance.

The good news is that you may be able to do something about balance problems. Studies have shown that programmed exercise, dance, Physical Therapy (PT), yoga, and Tai Chi can all help. Interventions depend on the particular issue.

In the case of inner ear dysfunction, vestibular rehabilitation with a therapist is the way to go, and an over-the-counter medication called meclizine might help (ask your doctor).

In the case of stroke, there is no substitute for PT and ongoing efforts by the patient. Therapists show patients how their balance is failing, and how to correct or compensate for the issue. If this is practiced enough, it becomes a new pattern for the brain; repetition is very important. PT is also very helpful in Parkinson’s Disease, for which programs have been developed to address balance.

Tai Chi may be used for a variety of balance issues. With this intervention, one focuses on center of gravity, breathing, posture, core, and limb strength. Learning Tai Chi requires an instructor, and may be more work than one expects, but it tends to pay off.

Likewise, in yoga, balance, core, and leg strength are all emphasized. An instructor is needed, though yoga can be started with a walker or a wheelchair. Chair yoga is a common approach for older participants.

Programmed dancing has been shown in studies to help not only balance, but also endurance and quality of life. Lifting weights improves muscle and bone strength. Lastly, nearly any exercise is generally useful for improving and maintaining balance. Older people who become sedentary and don't exercise are likely to find that they are no longer as stable on their feet. It is a use-it-or-lose-it situation.

Stay active, pick an exercise you enjoy, and work on balance. If you have a problem with balance, talk with your doctor about what is happening. There may be a way to make things better.

More Info
Health Within Reach:

Wednesday, January 23, 2019
5:30–7 p.m.

Mid Coast Center for
Community Health & Wellness
329 Maine Street–South Entrance, Brunswick

Calendar Highlights
Summer Meditation Series
Aug 24, 2022
Youth Mental Health First Aid Training
Sep 20, 2022
More Info
Health Within Reach:

Wednesday, January 23, 2019
5:30–7 p.m.

Mid Coast Center for
Community Health & Wellness
329 Maine Street–South Entrance, Brunswick

Calendar Highlights
Summer Meditation Series
Aug 24, 2022
Youth Mental Health First Aid Training
Sep 20, 2022
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