Causes of Dizziness Same in Young, Old

Sept. 19, 2007 -- Dizziness is one of the most common complaints of the elderly, but its causes are no different in older people than in any other age group, new research shows.

As many as one in three people over age 65 experience frequent dizziness, according to one study. Because the condition occurs so often, it has been suggested that a specific syndrome linked to aging is a major cause.

But in one of the largest studies ever to examine the question, a researcher who has studied dizziness for more than two decades found no evidence in support of such a syndrome.

"I saw no hint of any special type of dizziness exclusive to aging," Montreal Dizziness Clinic Director Athanasios Katsarkas, MD, tells WebMD. "The diseases which cause dizziness in the elderly are exactly the same as in other age groups. But dizziness is often a more serious problem in older people because they are frail or because there is more than one cause."
Dizziness in the Elderly

Katsarkas presented findings from his study in Washington, D.C., at the annual meeting of the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF).

He reviewed the cases of 3,427 patients who were over 70 years old when they sought treatment for dizziness at the Montreal clinic. Roughly one out of six patients in the clinic was in this age group.

Sixty-one percent of these elderly patients treated at the clinic were women; the average age was 76.

No definite diagnosis was found to explain dizziness in roughly a quarter of the elderly patients included in the study.

Most patients were diagnosed or strongly suspected of having benign paroxysmal positional vertigo (BPPV), an inner ear problem characterized by brief bouts of dizziness and nausea following certain head movements. BPPV is more prevalent in the elderly.

Other causes of dizziness included medications, Meniere's syndrome -- characterized by hearing problems, ringing in the ears, and dizziness -- and other diseases.
Diagnosis and Treatment

The message, Katsarkas says, is that the cause of dizziness can be identified in most elderly patients, but a diagnosis often takes time and careful follow-up.

"Dizziness is not inevitable with aging, and telling older people that they just have to live with it is unacceptable," he says. "A diagnosis is usually possible when the physician takes the time to get a good patient history and follows up with the patient."

Finding the cause or causes of dizziness is essential for treating the condition in elderly patients. A good first step in diagnosis is careful evaluation of the drugs a patient takes, Katsarkas says.

Drugs used to treat high blood pressure are a common cause of dizziness in the elderly.

"When the medication is changed, the dizziness often goes away," he says.

Other treatments include antidepressants or antianxiety medications if a psychological cause is suspected.

Or treatment may be as simple as getting out of bed on a particular side, Katsarkas adds.

"If a person who has vertigo in the right ear gets out of bed on the left side, that can make a big difference," he says.