Disturbances in walking, also known as "gait disorders," are common in older people and often can be treated before they become debilitating.

People with gait disorders often walk as if they are on thin ice - moving more slowly, taking shorter strides, spending more time with both feet touching the ground, and trying to find things to hold onto.It is estimated that gait disorders affect about 15 percent of people over the age of 60.

Lori Hovenstine, supervisor of the Outpatient Physical Therapy Department at New York University Medical Center, said gait disorders are not a normal consequence of aging but a direct result of one or more physical or medical conditions.

The problem may be caused by a number of different factors: poor vision or balance, lack of muscle strength, diminished sensation in the feet, decreased endurance due to respiratory difficulties, neurological damage (as from stroke), decreased range of motion in the joints, or side effects of certain medications.

Gait disorders may cause people to become less active, and this in turn may cause them to become weaker. "Once that starts, the problem will worsen," Hovenstine said.

The best prevention is regular exercise, she advised. People need to have the capacity for activity levels well above what is needed for day-to-day functioning so that they will have enough energy in reserve in case of illness or injury.

For instance, when a person whose most intense activity is walking lies in bed for two weeks with the flu, that person will now find ordinary walking to be exhausting.

Older people who develop gait disorders should consult their physicians about possible referral to a physical therapy program, only after a full medical and neurological evaluation is completed. Without appropriate guidance, attempts to physically recover after a temporary illness are often inadequate and function is lost.

Something as simple as the common cold may be devastating to endurance and ability to participate in everyday activities. This becomes a vicious cycle until the elderly can no longer care for themselves.

The evaluation can help to isolate the specific cause of gait disorders. For the patient with gait disturbances, special physical therapy can help to the sence sense of balance.