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Tips for Fall and Balance Safety

Grace, Jennifer AuD

doi: 10.1097/01.HJ.0000582456.47515.1f
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Dr. Grace is the clinical director at Newport-Mesa Audiology Balance & Ear Institute located in Newport Beach, CA. She is a vestibular audiology specialist who conducts research, presents, writes, and contributes in the areas of dizziness, vertigo, balance disorders, tinnitus, and hearing loss.

Falls among older people (aged 65+) are widespread and growing. According to the Centers for Disease Control and Prevention (CDC), one in four older adults falls each year, and one in every five of those falls results in serious injury, such as a broken bone or head injury. Alarmingly, fall death rates in the United States have increased by 30 percent from 2007 to 2016.1

Problems with walking and balance are an obvious fall risk factor. So it's not surprising that research reports 80 percent of people aged 65 and older in the United States have experienced balance disorders such as dizziness and vertigo.2 Of these balance disorders, vestibular (inner ear) dysfunction is a leading cause. In fact, 35 percent of adults 40 years or older in the United States have experienced vestibular dysfunctions.3

Less obvious is the audiometric portion of the ear and how it may contribute to fall risk. A study at the Johns Hopkins University School of Medicine and the University's Bloomberg School of Public Health found that people with at least 25 dB hearing loss are three times more likely to report a fall. Each 10 dB increase in hearing loss raises the chance of falling by 1.4 times.4

At the onset of balance disorder or hearing loss symptoms, a primary care physician or internal medicine doctor typically determines and refers the patient to the most appropriate specialist, such as an otolaryngologist (ENT), a cardiologist, a neurologist, or an audiologist. Common intervention strategies include medication, surgery, therapy (the most common and least invasive), or assistive hearing device.

Health care technology provides the most promising approach to address these issues. Expanding at an amazing rate, health and medical technology now spans artificial intelligence, virtual health care, nanomedicine, virtual reality (VR), 3D printing, and big data.

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TECHNOLOGY FOR BALANCE DISORDERS

Twenty years ago, the standard diagnostic test battery for identifying vestibular dysfunction was video nystagmography (VNG) and caloric testing. Recent research shows that 68 percent of patients with vestibular dysfunction are missed when only VNG is performed.5 In an age of technology enlightenment, if a full diagnostic test battery isn't completed, answers like “your tests are normal” or “just live with it” are outdated. Seek out a specialist who provides a comprehensive diagnostic test battery of all five end organs in each inner ear.

In this hyper-connected world, computers, mobile phones, cars, homes, and even your household pets, can be remotely monitored. So goes the trend in health care. Virtual health care seeks to extend the reach of medical care out of the office and into patients’ homes, allowing doctors and specialists to virtually monitor and treat patients in between office visits. VR devices are the new buzz for intervention of phobias, addictions, and lazy eye, to name a few. Several in-office VR programs and devices are in development for therapy and treatment of various balance disorders. However, a home-based VR treatment system for patients with dizziness, vertigo, and imbalance would provide the most patient convenience and clinical flexibility. These advances also promise to make health care more accessible, continuous, and effective.

Look for a balance center that provides both in-office and home-based treatment to receive the most enhanced, individualized, and effective treatment.

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HEARING TECHNOLOGY OPTIONS

Research shows that hearing loss can lead to cognitive decline, such as incoordination and difficulty completing normal daily activities, increasing the risk for falls and other injuries.6

Many technologically advanced hearing devices are available to correct individual hearing loss, providing customized speech recognition and improved overall hearing. These devices can be adjusted remotely and connect to mobile phones, televisions, and even doorbells, providing additional lifestyle enhancements. However, the U.S. FDA reported that only one-fifth of people who could benefit from these hearing devices actually seek them out.7

Ask a specialist about advanced hearing devices, including extended wear options. It can benefit more than just your hearing.

Advances in general medicine and audiology are often linked to technological innovation. Follow the technological advances and you'll find a more balanced future.

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REFERENCES

1. DC. Important Facts about Falls, 2017. Available from: https://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html
3. Agrawal, Y; Ward, B; and L, Minor. J Vestib Res. 2013; 23(3): 113-117.
4. Lin, F & Ferrucci, L. Arch Intern Med. 2012 Feb 27; 172(4): 369-371.
5. Won-Ho Chung and Hosuk Chu. Clinical Role of Rotary Chair Test, ENG and CDP. Otolaryngology-HNS 2010 143: P226.
6. Lin, F & Ferrucci, L. Arch Intern Med. 2012 Feb 27; 172(4): 369-371.
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