Balance Problems in the Elderly with Diabetes Mellitus: A Literature Review.

Diabetes mellitus (DM) is a syndrome of chronic metabolic disease which leads to all kinds of complications. Elderly people with DM have significantly higher fear of falling and balance problem scores as compared to those who did not have DM. This literature review aims: (1) to determine the risk factors for balance disorders in the elderly population with DM, (2) to describe valid and reliable balance measurement tools in the elderly population with DM, and (3) to describe the nonpharmacological management in dealing with balance disorders in the elderly population with DM. Several risk factors that cause balance disorders in the elderly with DM are related to complications of the disease they suffer, such as diabetic peripheral neuropathy, decreased sensory abilities, decreased motor skills, and decreased cognitive condition of the elderly with DM. Measuring instruments that can be used in the elderly population with DM to assess balance include the Mini-Balance Evaluation Systems Test, the Berg Balance Scale, and computerized measuring instruments with center of pressure analysis. Several nonpharmacological interventions are suggested in overcoming balance problems in the elderly with DM, including a combination of balance exercise and gait training, strength or resistance training, aquatic exercise, tai chi, yoga, technology-based exercise, electrotherapy, use of insoles, and whole-body vibrations.