Should I Worry About Dizzy Spells?

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This Week's Question: I'm not sure what's going on, but, once in a while, I find myself losing my balance. Is this just an aging thing or what?

About one in ten people over 65 experience difficulty with balance. More than 40 percent of Americans will go to a doctor complaining of dizziness. Getting older is only part of the problem. Inner-ear disturbances are the primary cause.

Losing balance when you're older is serious stuff. The Centers for Disease Control and Prevention reports that, each year, more than one-third of people over 65 years suffer a fall. Falls are the leading cause of injury deaths among older adults. And, even if the fall doesn't kill you, you could fracture a hip and then a whole bunch of problems will can cascade over you — limitations on activities, isolation, loss of independence, depression.

Not all balance problems have the same cause. Here are several major ones:

Benign paroxysmal positional vertigo (BPPV). With BPPV, one of the most common causes of balance problems, you get vertigo when you change the position of your head. You may also experience BPPV when you roll over, get out of bed, or when look on a high shelf. BPPV is more likely in people over 60.

Labyrinthitis, an infection or inflammation of the inner ear. The labyrinth is the organ in your inner ear that enables you to maintain balance.

Ménière's disease, which also can give you intermittent hearing loss, a ringing or roaring in the ears, and a feeling of fullness in the ear.

Other causes may involve another part of the body, such as the brain or the heart. Aging, infections, head injury, certain medicines, or problems with blood circulation may also cause problems with balance.

Blood-pressure medications and some antibiotics can cause balance problems. If you are taking any drugs in these categories and feel off-balance, it's worth discussing with your doctor.

Some people may have a balance problem and don't know it. Balance disorders can be difficult to diagnose because patients sometimes can't describe their symptoms well.

Balance disorders can be signs of other health problems, so it's important to have them checked out.

If you can answer any of the following positively, discuss the symptom with your doctor.

Do I feel: Unsteady? Disoriented? As if the room is spinning? As if I'm moving when I'm still? As if I'm falling? As if I might faint?

Also, do you ever lose your balance and fall? Or, do you experience blurred vision?

Persistent balance problems are not something you should pass off as a harmless part of the aging process. They should always be examined carefully.

• Last Week: Do Older People Need More Sleep?

The Healthy Geezer column publishes each Monday on LiveScience. If you would like to ask a question, please write fred@healthygeezer.com. © 2009 by Fred Cicetti.