Dizziness in the Elderly: Diagnosing its Causes in a Multidisciplinary Dizziness Unit

Abstract

We conducted a studytodetermine thecauses ofdizziness inpatients aged 70years and older whohad been referred to our multidisciplinary dizziness clinic between Nov. 1, 2000, and Dec. 31, 2008. Thispopulation wasmade up of 731 patients-254 men (34.7%) and477 women (65.3%). Duringtheir consultations, allofthesepatientswere evaluatedsimultaneously byanENTsurgeon anda neurologist. We were able to identify the cause of dizziness in 620 of these patients (84.8%). The twomostcommoncauses were benign paroxysmal positional vertigo (BPPV), which was found in202patients (27.6%), andhyperventilationtanxiety, which wasdiagnosed in 112 patients(15.3%). Based onourfindings, weconclude thatthecause ofdizziness can beestablished in the vast majorityof elderly patients. We also compare ourfindings in these olderpatientswiththose of agroup of2,556 younger patients whowere seen at our hospital and with thefindings reported in otherstudies.

A Geriatric Perspective on Benign Paroxysmal Positional Vertigo

“…This suggests a potential role for underlying processes as distinct and diverse as orthostatic hypotension and benign paroxysmal positional vertigo (BPPV). In the context of individuals referred to otolaryngologists or referral clinics, BPPV is the most common cause of dizziness, especially in older adults . In frail older adults seen by geriatricians, nonotolaryngological factors such as postural hypotension, cataracts, gait abnormalities, diabetes mellitus, and past myocardial infarction are important contributors to dizziness .…”

“…In the context of individuals referred to otolaryngologists or referral clinics, BPPV is the most common cause of dizziness, especially in older adults. 2,3 In frail older adults seen by geriatricians, nonotolaryngological factors such as postural hypotension, cataracts, gait abnormalities, diabetes mellitus, and past myocardial infarction are important contributors to dizziness. [4][5][6] As such, dizziness is considered a multifactorial condition, with features of a geriatric syndrome.…”

Risk Factors for Positional Vertigo and the Impact of Vertigo on Daily Life: The Korean National Health and Nutrition Examination Survey

“…Among them, benign paroxysmal positional vertigo (BPPV) is the most common form of PV, which impairs quality-of-life (QoL) and increases the risk of falls [1,2]. The average annual incidence of PV ranges from 11 to 64 per 100,000 and peaks in subjects aged 50-70 years [3]. PV is associated with vestibular dysfunction or imbalance, abnormal otolith positioning (in BPPV), and cerebral dysfunction [4].…”

Doença de Meniere no idoso

“…Vários trabalhos têm demonstrado que: (1) está aumentando o número de casos com início dos sintomas acima dos 60 anos de idade, (2) está aumentando o número de mulheres acometidas, e (3) está também aumentando o número de casos bilaterais nesta faixa etária. [4][5][6] Van Leeuwen RB e colaboradores (2014) 5 analisaram 731 pacientes acima de 70 anos e verificaram que a síndrome de Meniere atingia 5,2% deles e que as mulheres surgiam numa proporção de quase 2 para 1.…”