DEAR DR. ROACH: For the past couple of years, I have been noticing that my balance is not what it was. I never feel as though I am going to faint or pass out, but I find myself “listing,” and it is very uncomfortable. My doctor has changed my blood pressure medication, but it has not helped. I am 82 years old. I try to walk regularly, but feel I may look a little tipsy. — E.H.

ANSWER: Loss of balance as we get older is very important and often overlooked. Many different systems are involved — eyesight, joints, nerves and muscles are all necessary for proper balance, and all can be affected by aging. Fortunately, there is effective treatment for almost everybody.

Walking is great, and regular exercise of any kind will help your balance. But you need to be safe. Walk with someone, if possible; if not, walk where there are people, and have your phone. If you are unsteady, the best approach would be to get some help right away. Talk with your physician, who can work with you to decide the best place to start.

In my experience, physical therapy is the best way to prevent a fall — and a fall is potentially devastating. The therapist can help diagnose what is making you unsteady and can help design a program to get you stronger and safer. A physical therapist also can help decide if an aid, like a cane, will be helpful or harmful. Many community centers have programs that can help.

If you have already had a fall, then you may need even more help. In that case, make an appointment to see a neurologist, a joint specialist or a rehabilitation specialist. But everyone can improve with balance and strengthening exercises.

DEAR DR. ROACH: I am 91 years old and have just been told I have blepharitis, which I have never heard of. Please tell me the cause and treatment. It affects my reading. — C.E.

ANSWER: Blepharitis is inflammation of the eyelid (one or both). It can be caused by excess oil on the skin or by bacteria. Once we get older than 80 or so, the skin of the lower eyelid tends to droop, exposing part of the inside of the eyelid to the air. This can make inflammation of the lower eyelid more likely in older people.

While there isn’t a cure for blepharitis, most people get better with regular washing of the eyelids (use a dilute mild soap or “no tears” baby shampoo). A warm compress ahead of time can loosen up any crusting that might occur. You may need to do this several times a day at first.

Blepharitis sometimes brings with it blurry vision, but return to your eye doctor soon if your vision doesn’t get back to normal.

DEAR DR. ROACH: We in New York State are suffering through a serious cold and flu season. I’m wondering what role a toothbrush plays in it. I try to replace mine every one or two months and submerge it in boiling water regularly. Does this make a difference? — L.S.

ANSWER: Flu is transmitted from person to person, either through hand contact (hand to hand, or hand to object to hand) or in the air. The best way of avoiding flu is not getting exposed to the virus, and you can reduce that with meticulous hand-cleaning. The flu vaccine reduces flu from both hand contact and aerosol.

Regularly changing your toothbrush is a good idea for oral hygiene, but not to prevent flu.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from www.rbmamall.com.

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