Q: Why do older people often lose their balance when walking on thick carpeting or on the beach?

A: The ability to maintain balance relies on information that the brain receives from the eyes, muscles, joints, and vestibular organs in the ear. If any part of an older person's balance system is impaired, it could hurt the ability to adjust to ground surfaces. Problems with vision, knees, and hips and diseases like Parkinson's also can affect mobility, especially on a gravel driveway, thick carpeting or on the beach.

Exercises can help strengthen muscles, improve range of motion, and improve reaction time to minimize falls. Minor adjustments to the home can help, too.

Some useful tips for preventing falls include:

Exercise and diet. Keep your bones healthy with weight-bearing exercise. If you cannot walk or stand well, your doctor may refer you to programs that build strength and offer tips on healthy eating.

Know your drugs. Tell your doctor if your drugs make you dizzy or drowsy.

Check your vision. It is hard to get around safely if you can't see well. Make sure your glasses or contact lenses are the right strength.

Keep your home safe. Clutter, poor lighting, and small area rugs can cause falls. Use nonslip mats in your bathroom and curtains or shades to reduce glare. Use brighter lightbulbs or more lights. Have grab bars installed in your bathroom and handrails on your stairs.

Wear good shoes. Wear shoes with nonslip soles. Don't go barefoot or wear slippers.

Stuart A. Scherr, M.D., is medical director of the balance program at Nazareth Hospital's Center for Physical Therapy, Rehabilitation and Balance 215-335-3954.