Mobility changes due to aging are treatable
By Monique Giroux, MD, East Denver LIVING WELL Magazine
A change in mobility is one of the most common problems I see in my clinic. Common complaints are:
- “I can’t walk as far as I used to.”
- “I feel more unsteady or dizzy and need to grab onto something.”
- “I am stumbling or tripping over my own feet.”
- “My legs give out when I walk or stand.”
- “My walking has really slowed down.”
Unfortunately, many patients I see for consultation have already experienced a fall. Falls are serious in older adults, and often prompt a move to an assisted living facility or a nursing home and can lead to more significant problems. Each year, about one in three adults over 65 years of age fall due to associated medical problems, and a slowing of protective reflexes.
Under recognized is the emotional distress, decline in daily activities, increased dependence and reduced socialization due to fear of falling.
The common questions asked are “what is the cause, is this going to get worse, and can it get better?” Many causes of mobility problems are reversible and treatable. They can also be a sign of a more serious brain or nervous system condition.
Balance problems can be avoided and minimized with early intervention. Walking and balance problems are usually caused by more than one problem, so a multidisciplinary approach to treatment is best. This includes a comprehensive medical evaluation, physical and/or occupational therapy by experts specialized in movement focused on the following key factors.
Medical Factors:
- Nerve and Brain – Aging and disease affect control of balance, coordination, strength and sensory processing. Some conditions that impact mobility––stroke, MS, Parkinson’s, diabetic neuropathy, normal pressure hydrocephalus.
- Cognition – thinking problems, mood and behaviors can increase fall risk.
- Cardiopulmonary – Heart, lung and blood pressure changes can cause dizziness, breathing problems and reduced endurance.
- Vision – vision problems increase fall risk.
- Inner Ear problems – Ear issues may cause of vertigo or dizziness.
- Medications – i.e., sleep, pain, blood pressure, and antidepressant medications.
- Deficiencies – Vitamin, electrolyte and hormonal deficiencies.
Physical Factors:
- Biomechanics – Pain, posture, joint health, muscle strength and stamina impact mobility.
Personal Factors:
- Activities (work, play, exercise)
- Deconditioning
- Environment (home or work)
- Footwear
- Diet
- Cane/Walker (Improper use or lack of compliance)
Monique Giroux, MD, is a movement disorders neurologist and Integrative medicine specialist that directs the Movement and Neuroperformance Center of Colorado’s Comprehensive Gait and Balance Clinic in Englewood, CO. More information is available at centerformovement.org or 303-781-0511.
