Self-Report Symptoms Differ Between Younger and Older Dizzy Patients

Abstract

The clinician should be aware of differences in self-report dizziness symptoms in older patients. Older patients who do not have vertigo may be told that their symptoms are normal for their age, when, in fact, they may have an undiagnosed vestibular system impairment.

Asking about dizziness when turning in bed predicts examination findings for benign paroxysmal positional vertigo

“…However, it should be pointed out that strong rotatory vertigo is somewhat less commonly reported in the elderly population [10,25]. One possible explanation being the decreased sensitivity of the vestibular organ and vestibular reflexes with age.…”

“…One possible explanation being the decreased sensitivity of the vestibular organ and vestibular reflexes with age. While younger patients report a four times higher presence of 'true' vertigo (an illusion of movement) compared to elderly, the latter more often describe their symptoms as a giddiness or a tendency to fall [25]. Nevertheless, dizziness is a frequent complaint in the elderly and BPPV is common in this group.…”

Dizziness and its association with walking speed and falls efficacy among older men and women in an urban population

“…From a clinical standpoint, the most commonly reported duration of dizziness was seconds and the most common triggers of dizziness symptoms (after rising from supine to sitting) were positional changes and head movements like turning or tilting the head backwards (Table 1). These symptoms are often prominent in benign paroxysmal positional vertigo (BPPV), which is common among older people and may create a sense of unsteadiness [10]. Since BPPV is a cause of dizziness that can be cured if treated, physicians should actively search for BPPV among older people reporting dizziness by positional changes [33].…”

“…balance have been shown to be more common among those simultaneously suffering from chronic diseases [8]. Other known risk factors for dizziness include locomotor disorders, knee or hip problems, impaired vision, number of medications, benign paroxysmal positional vertigo (BPPV) or vestibular hypofunction [6,[8][9][10]. Dizzy older people tend to be less active than the non-dizzy [8,11,12], potentially due to dizziness and poor balance increasing risk of falling [13].…”

Vertigo and Dizziness in the Elderly

“…Although the majority of these patients present benign balance disorders, ( 7 – 9 ), in the elderly, common causes of vertigo may manifest differently, with a more confusing constellation of symptoms, as patients tend to report less rotatory vertigo and more non-specific dizziness and instability than younger patients presenting with the same condition ( 9 ). Underlying this phenomenon is the progressive multimodal impairment of balance, including the loss of vestibular and proprioceptive functions, and the impairment of central integration of these and other sensory inputs associated with aging, which may also be called as presbystasis, presbyequilibrium, or multisensory dizziness ( 4 , 7 , 10 ).…”