Polyneuropathy: Types, Causes, Symptoms, Treatment, and More
Our Sense Of Balance Is Crucial To Prevent Falls
Posture and balance are critical for human movement and function, and are closely tied to the coordination of the musculoskeletal system.
Good posture involves aligning the body to minimise strain, thus promoting health and confidence.
Balance relies on sensory input and muscle control, with the brain integrating the signals to maintain stability.
Loss of balance can be caused by various factors, including:
> Inner ear problems
The inner ear plays a crucial role in balance as it houses the vestibular system, which detects changes in head position and movement.
Inner ear disorders, such as benign paroxysmal positional vertigo, vestibular neuritis or Meniere's disease, can disrupt the signals sent to the brain about body position, leading to dizziness and balance problems.
> Neurological conditions
These encompass a wide range of disorders that impact the brain and nervous system, exerting significant effects on various bodily functions, including balance.
These conditions disrupt the intricate network of signals between the brain, spinal cord and peripheral nerves, leading to disturbances in coordination, muscle control and sensory perception.
Examples of such neurological disorders include Parkinson's disease, multiple sclerosis (MS), stroke, brain tumours and peripheral neuropathy.
> Musculoskeletal issues
Problems of the muscles, joints or bones pose significant challenges to balance and stability, making individuals more susceptible to falls and injuries.
Arthritis, osteoporosis, muscle weakness, and injuries such as sprains or fractures, can all contribute to balance difficulties by causing weakness, stiffness or instability.
> Medications
Medications can significantly affect balance through various side effects, including dizziness, drowsiness, orthostatic (or postural) hypotension, blurred vision, muscle weakness, tremors, impaired coordination, cognitive changes and by altering sensory perception.
Classes of medications such as anti-histamines, blood pressure drugs, neurological medications, analgesics, anti-cholinergics, and psychotropic drugs such as serotonin reuptake inhibitors (SSRIs), can all contribute to balance disturbances.
Polypharmacy, i.E. The use of multiple medications, increases the risk of adverse effects and interactions that may further impact balance.
Healthcare providers should carefully evaluate medication regimens, especially in older adults and those with existing balance issues, to minimise the risk of falls and injuries.
Patients should communicate any balance-related symptoms or concerns to their healthcare providers for appropriate management.
> Vision problems
Vision is crucial for maintaining balance as it provides feedback about the environment and spatial orientation.
Visual impairments like cataracts, glaucoma and macular degeneration, can disrupt depth perception, making it challenging to navigate one's surroundings safely.
Cataracts cause blurred vision, glaucoma affects peripheral vision, and macular degeneration impairs central vision.
Early detection and interventions such as corrective lenses or surgical treatments, can help mitigate the impact of visual impairments on balance and enhance safety.
> Ageing
As people age, changes in the vestibular system, muscle strength, joint flexibility and sensory perception can affect balance.
Moreover, age-related declines in muscle strength and mass – a condition known as sarcopenia – can significantly impact balance and mobility.
Muscles play a critical role in providing support and stability to the body, particularly in maintaining posture and executing movements.
However, as muscle mass decreases and muscle strength diminishes with age, older adults may experience weakness and instability, making them more susceptible to balance impairments and falls.
Similarly, changes in joint flexibility and range of motion can contribute to balance problems in older individuals.
Stiffness and reduced flexibility in joints – often associated with conditions such as osteoarthritis or degenerative joint disease – can impair the body's ability to adjust and adapt to changes in position or terrain, increasing the risk of falls.
Furthermore, age-related conditions such as degenerative disc disease, characterised by the breakdown of spinal discs, can lead to spinal instability and impairments in posture and balance.
Loss of disc height and integrity may result in spinal misalignment and decreased support for the vertebral column, further exacerbating balance issues and increasing the risk of falls.
> Environmental factors
External factors significantly contribute to the risk of falls, especially for individuals with balance issues.
Uneven surfaces, poor lighting, cluttered spaces and inadequate footwear all increase the likelihood of falls.
Uneven surfaces disrupt the natural gait, poor lighting impairs visibility, clutter creates obstacles and inadequate footwear compromises stability.
Additionally, environmental factors like wet or slippery surfaces, further heighten fall risks.
Addressing these hazards through home modifications, improved lighting, clutter reduction and proper footwear selection, is crucial for fall prevention, particularly among older adults and those with balance impairments.
Preventing falls
Falls among older adults represent a significant public health concern, often resulting in serious injuries and complications that can impact overall safety and well-being.
As such, implementing effective fall prevention strategies is paramount to safeguarding the health and independence of older individuals.
These include:
> Regular exercise
This is a cornerstone in fall prevention efforts.
Engaging in physical activities that focus on improving strength, balance and flexibility, can enhance muscle tone and coordination, thereby reducing the likelihood of falls.
Activities such as walking, tai chi, yoga and strength training have been shown to fortify musculoskeletal health and bolster balance mechanisms, making them invaluable components of any fall prevention regimen.
> Reviewing medications
As mentioned above, certain medications can induce side effects that affect our balance.
Therefore, it is essential for older adults to speak to their doctor or pharmacist about the potential impact of the medications they are taking on their balance and coordination.
Adjustments to medication regimens, when necessary, can mitigate these risks and contribute to overall safety.
> Maintaining optimal vision
Poor vision can impede depth perception and spatial awareness, increasing the likelihood of missteps and accidents.
Routine vision check-ups and timely updates to prescription glasses or contact lenses are essential in ensuring clear vision and minimising fall hazards associated with visual impairment.
> Creating a safe home environment
Home safety modifications, such as decluttering living spaces, securing loose rugs, installing grab bars in bathrooms, and improving lighting, can significantly reduce fall risks within the home.
Clear pathways and well-lit areas facilitate safe navigation and minimise the potential for accidents.
Furthermore, the use of assistive devices can provide additional support and stability for older adults, particularly those with mobility limitations.
Canes, walkers, and handrails enable individuals to navigate their surroundings with confidence, reducing the risk of falls and promoting independence.
> Proper footwear
Wearing sturdy, properly-fitting shoes with non-skid soles enhances traction and stability, minimising the risk of slipping and tripping on various surfaces.
> Being aware of fall hazards
Being mindful of potential dangers in the surroundings, such as uneven surfaces, wet floors or obstacles, empowers individuals to take proactive measures to mitigate risks and prevent falls.
> Limiting alcohol consumption
Excessive alcohol intake can impair balance and coordination, heightening the risk of falls.
Moderate and responsible alcohol consumption practices are essential for maintaining safety and minimising fall-related injuries.
> Learning about fall prevention
Participation in fall prevention programmes and workshops can provide valuable education and resources for older adults and their caregivers.
These programmes often offer evidence-based strategies for reducing fall risks and improving safety awareness, empowering individuals to take proactive steps towards fall prevention.
> Staying active and engaged
Taking part in social activities and hobbies can contribute to overall well-being and resilience against falls.
Physical activity and social engagement promote physical and mental health, thus enhancing mobility, cognitive function and emotional well-being, which are essential components of fall prevention.
In summary, preventing falls among older adults necessitates a comprehensive approach that considers various factors encompassing health, lifestyle and surroundings.
By adopting the measures stated above, individuals can effectively mitigate their risk of falls, and uphold their independence and quality of life.
Collaboration with healthcare providers and caregivers is vital for devising tailored fall prevention strategies that address individual needs and circumstances.
Ultimately, prioritising efforts to prevent falls can significantly enhance safety, well-being and longevity in ageing individuals.
Datuk Dr Nor Ashikin Mokhtar is a consultant obstetrician and gynaecologist, and a functional medicine practitioner. For further information, email starhealth@thestar.Com.My. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader's own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
'Sitting Is The New Smoking': How Your Nine To Five Could Kill You
'Desk-bound individuals are at high risk for spinal injuries and chronic disease', says medical doctor.
Your full-time gig may pay the bills, but cementing yourself behind the desk could cost you more than just bouncing debit orders.
Desk-bound individuals who spend a bulk of their time seated are at high risk for spinal injuries and chronic disease.
So, while working well under pressure and crunching deadlines might earn you some brownie points with the boss, your love of labour could land you in hospital.
Here's how your nine to five can send you to an early grave.
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'Cheaper is better': Student cribs and holiday rentals bring in the big bucks Short-term pay, long-term painGeneral Practitioner at Netcare Medicross, Dr Bonke Sambulu said while 'sitting is the new smoking' it may not be an accurate comparison, the dangers of continually sitting for prolonged periods were a real concern.
Sambulu said individuals who spend most of their weekdays seated must prioritise posture and regular body breaks – or risk compromising their physical well-being.
"The effects of sitting at your desk all day may not be immediately apparent, but over time, ongoing sedentary behaviour impacts various vital functions of the human body, which requires movement to maintain health," she said.
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Mind your backSambulu pointed out that back and neck pain were common noticeable complaints among desk-bound workers.
While this may seem mild at first, Sambulu said this could increase risk for muscle and spine ailments in the long-run.
"Sitting for extended periods can cause certain muscles to weaken while others become tight, leading to imbalances that contribute to stiffness and discomfort, particularly if you are sitting incorrectly," she cautioned.
The doctor recommended adjusting chair and desk height, the position of the monitor and keyboard, and the placement of your mouse for better sitting position and reducing strain.
"Repetitive strain and poor posture, on the other hand, can increase the risk of discs slipping or herniating, causing pain, numbness, or weakness in the back and neck. These symptoms can also occur with spinal stenosis or the narrowing of the spinal canal," said Sambulu.
She further explained that spinal discs may become permanently damaged as continuous pressure accelerates "wear and tear", resulting in Degenerative Disc Disease.
"Likewise, neck arthritis, or cervical spondylosis, involves the degeneration of the vertebrae in the neck. Both conditions lead to chronic pain and limited movement."
Take regular breaksCautioning against lack of movement, Sambulu said it could result in muscle atrophy and weakness, particularly in the leg muscles, core and back.
As a result, spinal and joint support will be reduced, further increasing musculoskeletal pain, injuries and postural problems.
"Regular breaks from sitting and exercises to strengthen the muscles and the spine can help to prevent these conditions.
"Weight-bearing exercise helps maintain bone density and strength, an important preventative step against bone loss and osteoporosis later in life."
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Hypertension and diabetesThe more time you spend sitting, the less calories you burn, which can lead to weight gain and obesity – both risk factors for hypertension and diabetes.
Sambulu said a sedentary lifestyle is linked to metabolic changes, such as insulin resistance and the imbalance of lipids such as cholesterol, which increase the risk of diabetes and heart disease.
"Lack of physical activity also affects blood circulation and overall cardiovascular health, further contributing to the development of these conditions and others, such as blood clots and deep vein thrombosis (DVT). Poor blood circulation may also lead to varicose veins and leg swelling."
Furthermore, she said lack of movement can impair lymphatic circulation, increasing risk of infections and inflammation.
"Remaining seated for extended periods on an ongoing basis may also contribute to digestive issues such as constipation and bloating."
Compromised mental healthEmphasising the importance of staying active, Sambulu said physical activity was essential for mental health.
"Being active releases endorphins, our 'feel-good' hormones, and can boost serotonin — a neurotransmitter that helps regulate mood, sleep, and appetite.
"Physical activity has also been proven to reduce levels of stress hormones, such as cortisol and adrenaline, and to promote relaxation."
She explained that lack of physical activity can affect mood regulation, leading to feelings of lethargy, irritability, and low moods.
"Incorporating regular exercise into one's routine can help promote emotional well-being and improve overall quality of life," she said.
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Get up, don't just sitWhile you may not have a choice when it comes to showing up for work, you can certainly make it better.
Sambulu suggested incorporating physical activities like stretching, walking meetings, and desk exercises such as squats or leg lifts to counter the adverse effects of sitting from nine to five.
"Take the stairs over the elevators or escalators, and cultivate a healthy office environment with ample fresh air and sunlight whenever feasible."
If your employer is not fussy with the budget, then proposing standing desks could be worth the shot.
Nonetheless, staying physically active outside your working hours is equally important.
"By prioritising good desk health, you can mitigate the adverse effects of sedentary desk work," said Sambulu.
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Scientists Discover Key To Unlocking The Secret Of Degenerative Brain Disorders Like Alzheimer's
The development of NeuM, a novel neuron labeling technology, represents a major step forward in the fight against neurodegenerative diseases. By enabling selective labeling and high-resolution imaging of neuronal membranes, NeuM facilitates the detailed study of neuron structures and their changes over time. This technology promises to be a vital asset in understanding and developing treatments for conditions like Alzheimer's disease, offering hope for advancements in neurodegenerative disease research and therapy. Credit: SciTechDaily.Com
Scientists have developed 'NeuM', a neuron labeling technology enabling detailed observation of neuronal structure. Successful monitoring of neuronal changes for up to 72 hours.
Alzheimer's disease, Parkinson's disease, and stroke stand as the leading trio of neurodegenerative conditions. These disorders are marked by the dysfunction and gradual deterioration of neurons, the nerve cells. To grasp the underlying mechanisms of these neurological conditions and to forge treatments, it is essential to have labeling technologies that enable the visualization of neuronal changes under both healthy and diseased conditions.
A research team led by Dr. Kim Yun Kyung from the Brain Science Institute at the Korea Institute of Science and Technology (KIST), in collaboration with Professor Chang Young-Tae's team from Pohang University of Science and Technology, has announced the development of a next-generation neuron labeling technology called NeuM. NeuM (Neuronal Membrane-selective) selectively labels neuronal membranes, visualizing neuronal structures and allowing real-time monitoring of neuronal changes.
Researchers from Dr. Kim Yoon-kyung's team at KIST are utilizing the next-generation neuron labeling technology, 'NeuM,' to visualize neurons in real-time and examine high-resolution images. Credit: Korea Institute of Science and Technology
Neurons continuously modify their structure and function to transmit information from sensory organs to the brain, regulating thoughts, memories, and behaviors. Therefore, to overcome degenerative neurological diseases, it is essential to develop techniques that selectively label living neurons for real-time monitoring. However, current gene-based and antibody-based labeling technologies, commonly used to observe neurons, suffer from low accuracy and difficulty in long-term tracking due to their dependence on specific gene expression or proteins.
Advantages and Capabilities of NeuMNeuM, developed by the research team through the molecular design of neuronal cells, possesses excellent binding affinity to neuronal membranes, enabling long-term tracking and high-resolution imaging of neurons. The fluorescent probes within NeuM bind to neuronal membranes utilizing the activity of living cells, emitting fluorescent signals upon excitation by specific wavelengths of light. This visualization of neuronal membranes allows for detailed observation of neuronal terminal structures and high-resolution monitoring of neuronal differentiation and interactions.
Molecular design for selective labeling of neuronal membranes. Credit: Korea Institute of Science and Technology
NeuM, as the first technology to stain cell membranes through endocytosis in living neurons, exhibits selective reactivity towards living cells, excluding dead cells without internalization. Moreover, the research team has succeeded in extending the observation time of neurons from a mere 6 hours to up to 72 hours, enabling the capture of dynamic changes in living neurons over an extended period in response to environmental changes.
NeuM is expected to provide insights into research and therapy development for degenerative neurological diseases, for which there are currently no cures. These diseases, including Alzheimer's, result from neuronal damage due to the production of toxic proteins such as amyloid and the influx of inflammatory substances. NeuM's precise observation of neuronal changes can effectively facilitate the evaluation of candidate therapeutic compounds.
Dr. Kim stated, "NeuM, developed this time, can distinguish aging and degenerating neurons, becoming a crucial tool in elucidating the mechanisms of degenerative brain disorders and developing treatments." He further added, "In the future, we plan to refine NeuM for even more precise analysis of neurons by designing fluorescence wavelengths to distinguish colors such as green and red."
Reference: "NeuM: A Neuron-Selective Probe Incorporates into Live Neuronal Membranes via Enhanced Clathrin-Mediated Endocytosis in Primary Neurons" by Yoonsik Sung, Lizaveta Gotina, Kyu Hyeon Kim, Jung Yeol Lee, Seulgi Shin, Hira Aziz, Dong Min Kang, Xiao Liu, Na-Kyeong Hong, Hong-Guen Lee, Jun-Seok Lee, Hyeyeong Ku, Cherlhyun Jeong, Ae Nim Pae, Sungsu Lim, Young-Tae Chang and Yun Kyung Kim, 07 December 2023, Angewandte Chemie International Edition.DOI: 10.1002/anie.202312942
This research was supported by the Ministry of Science and ICT (Minister Lee Jong-ho) through KIST's major projects and the Dementia Overcoming Project (RS-2023-00261784).
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