Quick answer: Balance problems in older adults have many possible causes: some medicines, inner-ear problems, weaker muscles, vision or foot problems, blood pressure that drops when you stand up, and conditions such as diabetes or heart disease. Because causes differ, it is worth telling your doctor if you feel unsteady, dizzy, or have fallen. Strength and balance exercises, a few times a week, can help you feel steadier.
Common causes
- Medicines. NIA advises checking with your doctor if you notice balance problems while taking certain medicines. Do not change or stop any medicine yourself. NIA also says: “The more medications you take, the more likely you are to fall.” (NIA, reviewed 12 Sep 2022)
- Inner ear (inflammation of the inner ear can cause vertigo and imbalance), alcohol, and other conditions. (NIA)
- Muscle loss (sarcopenia), gait problems, blood pressure that drops when you get up from lying or sitting (postural hypotension), foot pain and unsafe footwear, and changes in eyesight and hearing. (NIA falls page)
- Balance problems often start suddenly, with no obvious cause. About 15% of US adults (33 million) had a balance or dizziness problem in 2008. (NIDCD, last updated 6 Mar 2018: an old statistic)
- A 2015 peer-reviewed review reports that dizziness interferes with the everyday activities of 30% of people over 70. Common causes include sensory deficits, benign paroxysmal positioning vertigo (treatable with specific physical maneuvers), sedative or blood-pressure medicines, loss of muscle mass, and fear of falling. (Jahn et al., Dtsch Arztebl Int 2015)
- Falls are common: “More than one in four people age 65 years or older fall each year.” (NIA falls page)
A short balance self-check
These are the questions NIA and NIDCD suggest asking yourself, in plain words. It is a list of questions, not a score. If you answer yes to any of these, it may be time to talk with your doctor.
Tick any that happen to you
Nothing you tick is saved or sent. This check does not diagnose anything.
What to tell your doctor
Print this page and bring it, with notes on:
- How you would describe it, and whether it feels like spinning or not.
- Whether a movement triggers it or it happens when you are still.
- Other symptoms: hearing loss, ringing in the ears, ear pressure, headache.
- What makes it better, how often it happens and how long it lasts.
- Whether you have fallen, and when, where and how often.
- A list of all your medicines, including over-the-counter medicines and supplements.
A 10-minute balance routine
About this routine: the Healthy Agers team built this routine from exercises published by the NHS (“Balance exercises”, reviewed 7 Nov 2023) and NIA (how often to practise). The timing of about 10 minutes is our estimate. It is not a published program and not medically reviewed. The NHS page is due for review on 7 Nov 2026.
Do these near a wall or sturdy chair, in comfortable clothes, and build up slowly.
- Sideways walking: 10 steps each way.
- Grapevine (cross-step): 5 cross-steps each side; fingers on the wall if needed.
- Heel-to-toe walk: at least 5 steps; move away from the wall as you progress.
- One-leg stand: facing the wall, fingertips touching; lift one leg, hips level, hold 5–10 seconds, 3 times each side.
- Step-up: slow and controlled, up to 5 steps each leg, with a railing or wall.
How often: the NHS says at least twice a week; NIA says to aim for about three sessions of balance exercises a week (“Three types of exercise”, reviewed 14 Jan 2025). NIA’s balance examples also include tai chi, yoga, walking backward or sideways, and practising standing up from a sitting position. NIA says strength and balance training can improve balance, and muscle strength helps prevent falls, so combine the routine with strength work: see trouble getting up from a chair. For more drills, see balance exercises for seniors.
Stay safe: stop if you feel dizzy, in pain or short of breath. Speak to a doctor first if you have not exercised for some time or have medical conditions (NHS older adults guidelines, reviewed 15 Aug 2024).
Everyday habits that lower fall risk
All from the NIA falls page (reviewed 12 Sep 2022):
- Stand up slowly. Getting up too quickly can make your blood pressure drop. Ask to have your blood pressure checked lying down and standing up.
- Get your eyes and hearing checked.
- Ask about medicine side effects.
- Get enough sleep: if you are tired you are more likely to fall.
- Limit alcohol.
- Wear non-slip, low-heeled shoes, not socks, on stairs. Keep your hands free on stairs.
- Fall-proof your home, and keep a charged phone with you.
- Do not let fear of falling stop you being active. Staying active helps prevent falls.
- If you fall: breathe, check whether you are hurt, crawl to a sturdy chair if you can, and get help or call your local emergency number (911 in the US).
Balance problems and blood pressure. NIA says balance problems linked to high blood pressure “may be managed by eating less salt, maintaining a healthy weight, and exercising”, and for low blood pressure suggests “drinking plenty of fluids such as water; avoiding alcohol; and being cautious regarding your body’s posture and movement”. NIA adds: “Consult with your doctor about making any changes in your diet or activity level.”
When to get medical help
Call your local emergency number now (911 in the US, 999 in the UK) if you have: chest pain or a squeezing feeling in the chest; sudden weakness or numbness in the face, an arm or a leg, especially on one side; sudden confusion, trouble speaking or seeing; fainting or collapsing; or a fall where you are hurt or cannot get up.
Book a visit with your doctor soon if: you have fallen since your last check-up, even without pain; the problem is getting worse over weeks; you are losing weight without trying; you feel dizzy, sleepy or unsteady after starting a new medicine; or you are simply worried.
For this page in particular:
- You feel dizzy, lightheaded or as if you might faint, or you have blurred vision, new hearing loss or ringing in the ears. The NHS says to see a GP if dizziness will not go away or keeps coming back (the NHS dizziness page was last reviewed on 21 Apr 2023 and its review date has passed).
- You have fallen. NIA: tell your doctor if you have fallen since your last check-up, even if you did not feel pain.
- Face drooping, arm weakness or speech problems are stroke signs and need emergency help. The NHS lists feeling dizzy or falling over among other possible stroke signs.
Never stop or change a medicine because of something you read here. Talk to your doctor or pharmacist first.
Questions people ask
What causes loss of balance in the elderly?
Some medicines, inner-ear problems, weaker muscles, vision or foot problems, blood pressure that drops when you stand up, and conditions such as diabetes or heart disease. Because causes differ, tell your doctor if you feel unsteady, dizzy or have fallen. Sources: NIA; NIDCD.
Why do I feel dizzy when I stand up?
Blood pressure can drop when you get up from lying or sitting (postural hypotension). The NHS advises lying down until the dizziness passes, then getting up slowly. If it keeps happening, see your doctor. Sources: NIA; NIDCD; NHS dizziness.
How can I improve my balance as a senior?
Balance exercises such as the routine above, plus activities like tai chi and strength training, can help. Build up slowly. Sources: NIA; NHS.
How do I prevent falls at home?
Stand up slowly, keep floors clear, wear non-slip low-heeled shoes, check your eyes, hearing and medicines with your doctor, and keep a charged phone with you. See the habits list above. Source: NIA falls page.
Can medicines cause balance problems?
Yes, some can. Tell your doctor or pharmacist if you notice balance problems while taking a medicine. Do not stop or change any medicine yourself. Source: NIA.
Is a balance problem a sign of something serious?
There are many possible causes, and most are not an emergency. But sudden weakness, confusion, or speech or face changes need emergency help. Source: NHS stroke symptoms.
Is there a balance test for seniors I can do at home?
The self-check questions above are a screening step, not a test with a pass or fail score. A doctor or physical therapist can test balance properly; NIA mentions exercises developed for the individual by a physical therapist. We do not publish pass or fail times. Source: NIA.
Your next step
- Balance exercises for seniors — the guide for this symptom.
- Take the Healthy Habits Check — 3 minutes, private.
- Join the community — free, by email.
Also useful: Trouble getting up from a chair · Strength training for seniors · Yoga for seniors · Chair pilates for seniors.
Sources
- NIA, Older Adults and Balance Problems (content reviewed 12 Sep 2022).
- NIA, Falls and Fractures in Older Adults: Causes and Prevention (reviewed 12 Sep 2022).
- NIA, Three Types of Exercise Can Improve Your Health and Physical Ability (reviewed 14 Jan 2025).
- NIDCD, Balance Disorders (last updated 6 Mar 2018).
- NHS, Balance exercises (reviewed 7 Nov 2023; review due 7 Nov 2026).
- NHS, Dizziness (reviewed 21 Apr 2023; its review date has passed).
- NHS, Symptoms of a stroke (reviewed 12 Sep 2024).
- NHS, Physical activity guidelines for older adults (reviewed 15 Aug 2024).
- Jahn K et al., Dizziness and Unstable Gait in Old Age: Etiology, Diagnosis and Treatment, Dtsch Arztebl Int 2015;112(23):387–393, doi 10.3238/arztebl.2015.0387.
Last checked 9 October 2026. All sources above were opened and read on that date.