This surprises a lot of people. Audiologists are associated with hearing, so it seems odd that they would have anything to do with balance. But the vestibular system, the part of the inner ear that controls balance, sits right alongside the hearing structures. Audiologists are specifically trained to test and treat problems in both.
Dizziness and vertigo in older adults are more common than most families realise, and more treatable too. The instinct is often to put it down to age and leave it at that. In many cases, there is a specific inner-ear cause that can be identified and addressed.
The most common is benign paroxysmal positional vertigo, usually called BPPV. It happens when tiny calcium crystals in the inner ear shift out of position and interfere with the balance signals the ear sends to the brain. The result is brief, intense episodes of spinning, often triggered by lying down or turning over in bed.
BPPV is treated with a canalith repositioning manoeuvre, the most well-known of which is the Epley manoeuvre. An audiologist guides your parent through a specific sequence of head movements to shift the crystals back into place. It often works in one or two sessions and the relief can be immediate.
Other conditions audiologists test for include Meniere’s disease, vestibular neuritis, and general age-related vestibular decline. The testing involved, which can include videonystagmography and caloric testing, looks at how well the inner ear’s balance system is functioning. These tests are not uncomfortable, though some people experience brief dizziness during them.
Falls are the leading cause of injury in adults over 65 in the United States, and inner-ear problems are a significant contributing factor. An audiologist who identifies and treats an underlying vestibular issue is not just helping with dizziness. They may be preventing a fall that changes everything.
If dizziness or balance problems are accompanied by hearing loss in one ear, a sensation of fullness, or tinnitus, that combination is worth getting evaluated sooner rather than later. It can be the pattern of Meniere’s disease, which responds well to early management.
For balance problems that do not have a clear inner-ear cause, audiologists will refer to physical therapists who specialise in vestibular rehabilitation, or back to an ENT or neurologist as appropriate. They are not trying to be everything. They are trying to point you in the right direction.
If your parent has been written off as just getting older when it comes to balance, an audiologist assessment is worth requesting. There may be more that can be done than anyone has suggested.