“I’ve started to feel more unbalanced lately, even having a fall. I don’t have any dizziness I’m over 90 years of age. I do the Epley manoeuvre daily, but it doesn’t help. What might be my problem?”

There are many reasons for increasing imbalance without dizziness as we age. Often, there are overlapping reasons. As a starting point, we suggest reading our Age-Related Dizziness and Imbalance page as well as visiting a general practitioner or geriatrician for a thorough physical checkup as well as a referral for testing of your vestibular system.

In addition, a physiotherapist will be able to assess your gait and muscle strength. It is likely that you can make progress towards greater stability be getting and practicing a set of exercises tailored for your needs by a physiotherapist.

The last thing you want is a serious fall. Ask about falls prevention workshops or classes in your area. A family doctor or physiotherapist should be able to help you with tracking down something suitable in your area.

In the meantime, be particularly mindful of your risk of falling, particularly on uneven ground, on stairs, and in the dark. Wear supportive shoes even inside. Our Falls Prevention page has many more tips. A physiotherapist will be able to give you more advice specific to your needs.

The Epley manoeuvre is helpful only for people with one specific condition, BPPV. The hallmark symptom of this condition is brief, spinning dizziness (vertigo) that lasts less than a minute. As you report not being dizzy, it is unlikely you have BPPV. While there is no harm in doing the Epley, it won’t help unless you have BPPV. As a retired engineer, you may find it interesting to read about the physics of displaced crystals in the inner ear on our BPPV page. It is an interesting topic.