What is Dizziness?
Dizziness is a term used to describe a range of sensations, such as feeling faint, weak, unsteady, imbalance and lightheadedness (1). Dizziness that falsely creates a feeling of spinning or moving in you or your environment is called vertigo.
Dizziness is among the most common causes of seeking medical treatments and can significantly affect life (2). It is rarely due to life-threatening disease. Treatment of dizziness depends on the underlying cause. Dizziness may occur with other symptoms like vomiting, sweating, nausea and feel faint.
Balance is provided by three important senses including inner ear, somatosensory system, and eyes. Disorder of each one of these senses can make a patient dizzy. Inner ear pathologies mainly cause true spinning vertigo. Sometimes dizziness caused by an underlying health condition, such as poor circulation, infection or injury. Some medications have dizziness as their side effect.
Dizziness in Elderly
Dizziness in elderly is quite common. Its prevalence reaches 30% in people aged more than 60 years old (3). Dizziness in elderly is a very serious condition as it may increase the risk of falling. Fall is the main cause of accidental death in people older than 65 years. The risk of hip and wrist fractures in fall is high (4). In elderly, there are many disorders like decreased visual acuity, diabetes and peripheral neuropathy, osteoporosis, muscle weakness, high blood pressure and heart disease. This population is on many different medications.
Mostly elderly complain about dizziness and true vertigo is less common. In elderly, presbystasis – the loss of vestibular and balance functions associated with aging – benign paroxysmal positional vertigo, and stroke should always be considered (5).
Accurate diagnosis of the underlying cause of dizziness needs multidisciplinary approach especially otolaryngologist, audiologist, neurologist, cardiologist and physical therapist. There is a need for comprehensive evaluation and considering subject’s medications. Thorough history taking is a key element.
Treatment will depend on the underlying cause. It can be medical or rehabilitation. Rehabilitation mostly performs by audiologists and physical therapist and helps overall balance and decrease falling risk.
- Iwasaki S, Yamasoba T. Dizziness and imbalance in the elderly: age-related decline in the vestibular system. Aging and disease. 2015;6(1):38.
- Nevitt MC, Cummings SR. Type of fall and risk of hip and wrist fractures: the study of osteoporotic fractures. Journal of the American Geriatrics Society. 1993;41(11):1226-34.
- Fernández L, Breinbauer HA, Delano PH. Vertigo and dizziness in the elderly. Frontiers in neurology. 2015;6:144.