Balance problems are not an inevitable part of aging. Many changes and conditions that happen with aging can cause balance problems 

Many older adults have more than one cause of poor balance.

Common Causes of Balance Problems

Neurological problems

• Neuropathy (weakness, numbness, or pain caused by nerve damage)
• Paralysis or weakness after a stroke
• Transient ischemic attacks (TIAs), also called “mini-strokes”
• Parkinson’s disease, a brain condition that can cause balance problems and other problems with movement

Musculoskeletal problems

• Physical deconditioning (being “out of shape”)
• Degenerative joint disease  (arthritis)
• Rheumatological conditions, such as Rheumatoid arthritis

Inner ear problems

Benign Paroxysmal Positional Vertigo (BPPV)

• Caused by crystals in the inner ear that have moved out of their normal position.
• Causes vertigo that lasts from a few seconds to a few minutes
• Vertigo triggered by changes in head position

Labyrinthitis

• Caused by inflammation of the inner ear, often from a viral infection like a cold or the flu
• Vertigo that starts suddenly and lasts for several days 
• Vertigo not usually related to head or body position
• Vertigo along with nausea and vomiting

Meniere’s disease

• Caused by a fluid build-up inside the ear.
• Vertigo lasting at least 20 minutes and often continuing for several hours
• Confirmed hearing loss
• Tinnitus (ringing in the ears) or a feeling of fullness in one ear

Sudden low blood pressure (orthostatic hypotension)

• A drop in blood pressure when sitting up or standing
• Causes dizziness or lightheadedness lasting from a few seconds to a few minutes after sitting or standing 
• Can also cause blurred vision, reduced hearing, head or neck pain, or sweating

Medications

Many medications can affect balance. Some of these include:

• Blood pressure medications
• Some medications used to treat Parkinson’s disease
• Some antidepressant and anti-anxiety medications
• Some anti-seizure medications
• Sleeping pills
• Opioid pain medications
• Nitroglycerin (a heart medicine), especially when taken with medicines for erectile dysfunction, such as sildenafil (Viagra) or tadalafil (Cialis)
• Some supplements and herbal products, including cannabis products

Taking more than one of these medications at the same time, or drinking alcohol while taking them, can make balance problems worse.

Other Conditions

Other health conditions can cause balance problems or make them worse. Some of these include:

• Dehydration (not drinking enough fluids)
• Low blood sugar from not eating enough
• Anxiety or panic attacks
• Allergies or infections
• Vision problems, such as cataracts, glaucoma, or macular degeneration

Tell your healthcare provider if you have new, strong, or ongoing balance problems, lightheadedness, faintness, dizziness, shakiness, weakness, instability, or a general feeling of being physically unsteady. These symptoms may be related to one or more conditions that can be treated.

Last Reviewed and Updated: October 2026 
By: AGS/HiAF Public Education Committee, HealthinAging.org Content Reviewers