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Q: Why does age affect balance, and what can help offset the change?

A: As we age, physical changes and health conditions often affect our balance, raising risk for serious injuries like hip fractures and head trauma. Everything we do to maintain our health, alertness, fitness and mobility will slow the trajectory of our declining balance.

Steady balance relies on input from your eyes, inner ears, nerves, muscles and joints — all processed by the brain. With advancing age, vision and hearing tend to diminish, nerve signals become less reliable, muscles lose strength and power and reflexes slow.

Yet good balance is the foundation for nearly every movement you make. Even if you are strong and flexible, poor balance can make routine tasks difficult — or unsafe. By identifying possible risks, you can take steps to improve your balance.

Three major categories of risk that can impair balance are those related to health, medication effects and your environment.

Health-related balance risks

Vision problems like cataracts, glaucoma and macular degeneration can hinder your ability to relay your location to the brain.

Inner ear conditions such as benign paroxysmal positional vertigo, infections or Meniere’s disease can cause vertigo.

Neuropathy, often from diabetes or spine issues, reduces sensation in legs and feet.

Foot conditions, like fallen arches, can alter gait and stability.

Orthostatic hypotension, a drop in blood pressure upon standing, can cause dizziness.

Mild cognitive impairment can affect your reaction time and ability to sense where you are in a space.

Medication-related balance risks

Certain drugs can make you woozy or unsteady, such as:

• Anti-anxiety drugs
• Older antihistamines, such as diphenhydramine (Benadryl)
• Blood pressure medications
• Diabetes medications
• Opioids and sleep aids

Environmental balance risks

Falls can also result from your surroundings and footwear choices:

• Outdoor hazards: uneven paths, paths blocked by shrubbery or large tree roots, poor lighting, snow, ice or rain, especially if you’re not wearing footwear that grips
• Indoor hazards: clutter, loose rugs, dim lighting, slippery floors, extension cords, pets or even ill-fitting slippers or shoes that keep you from sensing the ground properly

Ways to boost balance and avoid falls

• Remove home hazards and install safety features (grab bars, nonslip treads, handrails)
• Talk with your doctor if think balance issues are related to medication
• Wear supportive shoes with laces to keep them snug on your feet
• Build better balance: engage in activities like walking, yoga, tai chi or dance
• Try this exercise: Stand on one leg with the other foot lifted a few inches. Hold, then switch legs. Repeat 10 times each side. If you’re unsteady, position yourself near a counter or wall before trying the exercise. Practicing regularly will help.

Q: I suspect one of my necessary medications is causing an annoying metallic taste. What can I do to offset it?

A: Medications are the most common cause of a persistent metallic taste in the mouth, sometimes referred to as “metal mouth.” This type of taste distortion called dysgeusia occurs for a number of reasons.

Dry mouth from reduced saliva production tops the list. Common examples include antidepressants, antihistamines for allergies, or opioids to treat pain. A dry mouth can heighten flavors that are metallic or bitter.

Some drugs, such as the diabetes medication metformin, are excreted through the salivary glands and wind up in your saliva, so you taste them, and they often taste bitter.

Other medications, such as chemotherapy drugs for cancer, might stimulate taste receptors on your tongue that identify bitter or metallic tastes.

Metal mouth usually goes away once your body gets used to a medication or you stop taking it. To make the symptom more tolerable, consider the following strategies.

Stay hydrated. Increase your fluid intake (from drinks or watery foods like soup or fruit) or use artificial saliva, which comes in a spray or tablets. This dilutes the concentration of unpleasant-tasting substances.

Prepare your mouth for meals. Before eating, rinse your mouth thoroughly with water and a dash of salt or baking soda. This can rinse away or neutralize traces of the medicine on your tongue.

Try it cold. Some people find that chilled or room-temperature foods and drinks help disguise a metallic taste. Sipping on cold fruit-sweetened water between meals might also help.

Keep it simple. Eat whole, fresh foods prepared plainly, such as chicken, fish and steamed vegetables. Hold off on sauces, lots of spices or processed foods. Complex flavors, preservatives or artificial flavors may intensify the metallic taste of pills.

Avoid or limit red meat. Meats are high in iron and zinc, which can trigger a metallic taste. Try other proteins such as eggs, egg whites, fish, chicken, turkey breast, tofu, tempeh, nuts or cheese.

Use bamboo, wood or plastic utensils. Repeatedly taking bites of a meal with a metal fork or spoon might intensify a metallic taste.

Try a little sweetness. Some people find that naturally sweet foods, such as citrus, help mask a metallic taste. For example, add a spritz of orange to foods and drinks. And you might chew sugar-free gum between meals.

Brush and floss regularly. Microbes in the mouth can add to “off” flavors and a sour taste. Having a clean, refreshed mouth seems to help food taste better. You might also use a tongue scraper twice a day to remove bacteria and dead cells on the tongue’s surface.

Howard LeWine, M.D., is an internist at Brigham and Women’s Hospital in Boston and assistant professor at Harvard Medical School. For additional consumer health information, please visit www.health.harvard.edu.

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