BALANCE DIFFICULTIES IN ELDERLY PERSONS.
By Renato Cocchi, MD
Elderly persons, since a certain age, have
balance problems, and the situation that is the major spy of this trouble is
going on city busses, when they make the trip by standing up.
The trouble consists in the difficulty to
re-balance immediately the posture, after accelerations, decelerations and as
the effects of the centrifugal force in the road curves.
We need to remember that in the preceding
age same persons were able to compensate their own equilibrium to face these
forces that stretch instead to do lose it. So, we may think that the increase
of the age represents, as it is well known, an unfavourable factor even in this
field.
To simplify, when we consider the arc
"Vestibular pathways -> the cerebellum -> re-balancing
pathways," we have to think that at least one of these elements works
unsuitably. To the limit, all three could be ill-functioning.
In some depressive forms, rather than rare,
one reported symptoms, if the physician does a specific question, is the
disbandment feeling, which is the feeling of keeping not his/her own balance,
in an age even youth.
In facts, the person does not skid, and does
not put into action feedback answers, but he/she feels to skid. This leads to
think about an alteration of perception, by a cerebellar or cerebral origin.
This symptom often goes (not
contemporarily) with the feeling of fainting, with very short duration, which
goes over at once.
These two symptoms are not necessarily tied,
because more than once they are found as isolate, the one or the other.
Probably they have a different origin and their contemporary presence in the
same person only concomitance, and not the effect of the same cause.
Moreover, we are too much accustomed to
think that negative behaviour or a negative symptom depends necessarily on a
deficit. In facts, it could depend even on excess, and, if is so, I should
imagine the glutamate or other exciting neurotransmitters, as the imputable
first ones.
Italian translation
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