NEW YORK - Dick Sandhaus, a healthy and fit 62-year old, says he never gave his balance a thought until he lost it.
A wicked sprained ankle was the result. Now he practices balancing for a few minutes each day and urges his fellow baby boomers to do the same.
"Rocking toes to heels and quadriceps stretches are things anybody can do if they have a floor," said Sandhaus, a self-described ex-hippie who dispenses fitness tips on his website, BetterCheaperSlower.
"If you put yourself in instability it gives you instant awareness of what balance is about," he explained.
Having good balance means being able to control and maintain your body's position; having poor balance can have dire consequences.
According to the Centers for Disease Control and Prevention, more than one-third of adults 65 years and older fall each year. Falls are the leading cause of injury deaths among older adults.
Dr. Wojtek Chodzko-Zajko, an expert on aging for the American Council on Sports Medicine, said lack of balance among older adults is a huge problem affecting mortality and quality of life. But he cautions against painting all older adults with the same broad brush.
"Physiological decline is an inescapable consequence of ageing but the rate and extent varies tremendously," he said. "Lots of (people) 85 and over are more than capable of functioning."
Regular walking and resistance training will suffice for many older adults, according to Chodzko-Zajko, who heads the Department of Kinesiology and Community Health at the University of Illinois at Urbana-Campaign.
"Balance interventions need to occur for those with risk factors," he said.
And the biggest risk factor is falling.
"If you can ask only one thing, ask, 'Have you had a fall in the last six months?'" he said. " If they say, 'Yes,' then follow up with further testing."
He said vision problems, multiple medications, cognitive changes, and confusion are among other risk factors for imbalance.
"From a public health perspective, it's really expensive to test for all those things," he said.
If you have an ageing parent, Chodzko-Zajko advises, first try to make sure they're active. Then if they're at risk, talk to their physician about medication, install non-slip surfaces, get rid of clutter.
"Try to be as preventive as makes sense without being overcautious," he said. "You don't want people to stay at home."
Chodzko-Zajko said while he has no objection to tools such as balance boards, foam, obstacle courses, they are not a solution for everyone.
As a personal trainer with Equinox, a national chain of fitness centers, Margaret Schwarz routinely assesses the fitness level of new members at the New York club where she works.
The screening includes a balance component, but Schwarz says regardless of age, you can't have balance if you don't have strength.
"I approach it from a strength perspective. I watch them do squats, walk up stairs, pick things off the floor, do regular activities. (Lack of balance) can happen in a 35-year-old who has been sitting at a desk," she said. "Some women can't lift a three-pound dumbbell."
She said too many people can't feel the ground beneath their feet.
"Sometimes I have them take off their shoes to feel the floor," said Schwarz, who defines balance as being able to right yourself.
"It's about how to use your musculature in space," she said, "so when you feel yourself falling you can stop yourself from falling."