Disequilibrium of Aging

Disequilibrium of aging is a condition manifesting as ill-defined dizziness and gait unsteadiness. Loss of hearing and balance occur normally with age. Patients over the age of 70 may have a 20 to 40 percent loss of vestibular hair cells. In addition, elderly patients often experience a decrease in visual as well as proprioceptive input, a decline in central integration and processing, as well as a decrease in motor responses. Approximately 50 percent of individuals over the age of 70 experience imbalance; of those, more than half report falls.10 The disequilibrium of aging may be precipitated or exacerbated by diminished ambient light (with worsening of symptoms at night), unfamiliar surroundings, and the use of benzodiazepines and drugs with anticholinergic effects such as tricyclic antidepressants and neuroleptic agents. The concomitant presence of near syncope or risk factors for near syncope may complicate the diagnosis.

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