
One fateful morning, 75-year-old Ambika Devi suddenly felt the room around her spinning, reminiscent of an amusement park ride from her youth — but this was far from enjoyable, it was like a nightmare coming to life. Instead of the excitement of a thrill ride, the experience instilled a fear of perpetual instability. It wasn’t just dizziness — Ambika felt as though the world around her was tilting or moving, even when she was standing still.
Her first episode occurred as she was getting out of bed. It was so overwhelming that she fell to the floor, all the while clutching on to the nightstand for support.
She closed her eyes, hoping for relief. Though the vertigo lasted only about a minute, Ambika was left disoriented for hours and the experience left her terrified. As days passed, these episodes became more frequent and unpredictable, triggered by simple movements — like tilting the head faster, bending down to pick up clothes from the washing machine, or standing up after sitting for a while.
As a widow with children living far away, Ambika’s confidence in living alone was shaken by this sudden and unsettling change. Her experience, though deeply personal, is far from unique. Balance disorders in older adults are often overlooked, yet they can profoundly affect the quality of life.Determined to find answers, Ambika sought professional help after her condition didn’t improve. A family friend recommended seeing an ENT specialist or neurologist.
After tests at a neurology clinic, Ambika was diagnosed with benign paroxysmal positional vertigo (BPPV), a condition that affects the inner ear, causing brief but intense spells of dizziness. While dizziness is commonly used to describe many sensations, vertigo specifically refers to the feeling that either you or your surroundings are moving or spinning when there’s no actual movement.
BPPV is one of the most common causes of vertigo, affecting people of all ages, but it’s most prevalent in those over 50. It happens when tiny calcium crystals, known as otoconia, dislodge from their usual spot in the inner ear and move into one of the ear’s semicircular canals. These canals are responsible for detecting head movements and helping the body maintain balance. When the crystals are displaced, they send incorrect signals to the brain, creating a false sense of spinning or tilting.
Devastating consequences
Balance disorders are any conditions that interfere with the ability to maintain proper posture and equilibrium. While vertigo is a common form, there are other factors, including neurological issues, that can lead to balance problems. Neurological disorders affecting the cerebellum, for instance, can also cause dizziness.
“Balance is something we often take for granted, but when it’s compromised, it affects everything,” explains Dr Gigy Kuruttukulam, an interventional neurologist and medical director at Rajagiri Hospital, Aluva.
“One of the key things that set humans apart from animals is our ability to walk on two legs. Balancing on two legs is complex, and when a person loses the ability to walk without fear of falling, they quickly realise how essential it is. Most people with balance disorders experience psychological distress because it significantly impacts their mobility.”
The fear of falling often becomes so overwhelming that individuals are afraid to walk without support, adds Dr Kuruttukulam.
“This fear and the subsequent loss of independence can be devastating. Many people with balance issues stay confined at home, unable to go out without someone with them. The psychological effects of this can be profound,” he said
Can turn chronic
Emphasising the importance of early diagnosis and treatment, Dr Vinod Felix, consultant ENT at KIMSHEALTH Thiruvananthapuram, says that the condition is easier to treat in people between 25 and 60. “Around 10-15% of patients in OP seek help for balance disorders, and approximately 25% of those are due to positional vertigo. If the crystal imbalance is not addressed, it can lead to chronic vertigo. Chronic patients need reassurance, but this can be challenging, as their symptoms may periodically resurface.
In some cases, professional counselling may also be required,” he said. Patients typically consult an ENT specialist or neurologist who will conduct a detailed clinical history to identify triggers and associated symptoms. A thorough neurological and ENT evaluation is necessary to determine the underlying cause of the balance issues. Health experts stress the importance of interacting with patients and understanding the specific circumstances of their dizziness.
Dr Kuruttukulam also explains how to differentiate between balance disorders caused by inner ear problems and those related to neurological issues. “With inner ear disorders, patients often experience a sensation of spinning but can still walk without falling. In contrast, neurological problems often involve a pronounced loss of balance and difficulty in walking. These patients may immediately fall to one side.”
Neurological balance disorders can also be accompanied by symptoms like numbness or weakness on one side, slurred speech, facial drooping, or visual disturbances, such as double vision or loss of vision in a portion of the field of view.
Balance disorders — whether caused by inner ear issues, neurological conditions, or other factors — can have a profound impact on a person's life. For older adults, declining balance is not just inconvenient, it can be downright dangerous. According to the Centre for Disease Control and Prevention (CDC), one in four older adults experiences a fall each year.
While some balance issues may be seen as a normal part of aging, they can also signal underlying health problems. Fortunately, with early diagnosis and appropriate treatment, many people can regain their confidenceand independence.