Current Insights into Treating Vertigo in Older Adults

Abstract

The number of older people has been increasing over recent decades in Western populations. Dizziness, imbalance, and vertigo constitute some of the most common complaints in older patients, and risk of falling is the most frequent and worrying consequence. It has been reported that 15-20% of the adult population experiences these debilitating symptoms. Among the diseases that may be associated with vertigo, the three classes of otological, central, and functional (psychological) dizziness may be distinguished. Overall, vestibular disorders account for 48% of vertiginous complaints in the older population. The main focus of this article is to review the forms of pharmacotherapy for vertigo, especially with regard to older patients, who may be treated simultaneously with other drugs for different comorbidities. Interactions with other drugs should be considered in the choice of a particular course of treatment. Moreover, overuse of pharmacotherapy for the management of vertigo in the elderly may prevent the development of the central compensatory mechanism that sustains both static and dynamic imbalance after a vertiginous crisis. In the majority of patients, vestibular and physical rehabilitation are strongly advised and rarely contraindicated.

Quinazoline alkylthio derivative targets norepinephrine and calcitonin gene-related peptide to improve behavior and radiographic score in the rat model of cervical vertigo

“…It is reported that ET and CGRP function together for the regulation of blood flow and maintaining vascular function (Parlapiano et al, 1999). Studies have found that cervical vertigo development is closely associated with the imbalance in the production of ET-1 and CGRP and these two factors serve as important pathogenetic factors for the disorder (Casani et al, 2021;Wang et al, 2007). It has been found that regulation of ET-1 and CGPR levels in plasma dilates blood vessels of the brain as well as the inner ear thereby exhibiting a therapeutic effect on vertigo (Zhou et al, 2018).…”

Insights into Benign Paroxysmal Positional Vertigo in the Elderly

“…Approximately 30% of individuals over the age of 60 and nearly 50% of individuals over the age of 85 suffer from vertigo (2). Vertigo is a significant risk factor for falls in older adults and a remarkable cause of disability in those over 65 (3,4).…”

Potential effects of cannabinoids on audiovestibular function: A narrative review

“…Its key characteristics are the presence of rapidly-discharging EEG activity and a favorable response to antiepileptic therapy ( Hewett and Bartolomei, 2013 ). On the other hand, several anticonvulsants including diazepam, gabapentin and carbamazepine are used to treat several vestibular disorder subtypes, even those unrelated to seizures ( Casani et al, 2021 ). CBD is a proposed drug indicated for treating epilepsy.…”