Age-Associated Characteristics of Patients With Chronic Dizziness and Vertigo

Abstract

Objective: The incidence of dizziness and vertigo is increasing with age, and symptoms lead to significant limitations in daily living and to disability in older patients. Method: Data of 1,752 patients with chronic dizziness/vertigo subjected to a tertiary care, specialized interdisciplinary vertigo center were analyzed. Age, gender, symptoms, medical diagnosis, and Dizziness Handicap Inventory (DHI) were collected based on a questionnaire and analysis of associated patient records. The patients were assigned to 3 age groups (< 41, 41-65, and > 65 years). Results: 33.7% of the patients were older than 65 years. Frequency of symptoms and DHI score increased with age. Older patients reported less frequently about coexisting symptoms such as nausea, headache, tinnitus, ear pressure, and visual impairment. Multisensory deficit, central vertigo, bilateral vestibulopathy, and benign paroxysmal positional vertigo were diagnosed increasingly with age, while persistent postural–perceptual dizziness and vestibular migraine were diagnosed in the younger age groups. Conclusion: In the diagnostic work-up of older patients age-specific characteristics of dizziness/vertigo have to be considered. The older patient generally is more impaired by the symptoms but possibly will not report typical diagnosis-defining symptoms.

Impact of Common Dizziness Associated Symptoms on Dizziness Handicap in Older Adults

“…They had preserved mobility and the majority of patients were able to walk independently. In addition, the distribution of diagnoses changes with age (15). Thus, the results of our study cannot be generalized to the general population.…”

“…Totally 1,752 patients filled out the questionnaire and agreed to take part in the study. Some aspects of the analysis of these questionnaires have already been published elsewhere (15). For this study, we selected 785 questionnaires from those patients with chronic dizziness/vertigo aged 60 years and older.…”

“…In patients with vestibular disorders aged 65 years or higher, the DHI score has been shown to have a significant association with the Timed Up and Go test and usual gait speed using the timed 10-meter walk test (12). Older patients with dizziness score higher in DHI than younger patients (13)(14)(15) and also multimorbidity is correlated to higher DHI scores (16).…”

“…Here, patients with chronic dizziness or vertigo were assessed with symptoms lasting over more than 3 months. Dizziness and vertigo is not the same, but patients' description of vertigo and dizziness often is not suited to assign them to vestibular and non-vestibular origin (15).…”

How Healthcare Utilization Due to Dizziness and Vertigo Differs Between Older and Younger Adults

“…Data on the lifetime prevalence of dizziness and vertigo show an increasing prevalence of 30% to 50% in older people (2)(3)(4)(5). In older patients, multifactorial, degenerative, and chronic causes of vertigo/dizziness prevail (6,7). Older adults with dizziness often suffer from multisensory deficits, such as central vertigo bilateral vestibulopathy, and benign paroxysmal positional vertigo (8,9).…”