ear, nose, and throat disorders
Dizziness and Vertigo
Geriatrics Essentials: Dizziness and Vertigo
As people age, organs involved in balance function less well. For example, seeing in dim light becomes more difficult, inner ear structures deteriorate, proprioception becomes less sensitive, and mechanisms that control blood pressure become less responsive (eg, to postural changes, postprandial demands). Older people also are more likely to have cardiac or cerebrovascular disorders that can contribute to dizziness. They also are more likely to be taking drugs that can cause dizziness, including those for hypertension, angina, heart failure, seizures, and anxiety, as well as certain antibiotics, antihistamines, and sleep aids. Thus, dizziness in older patients usually has more than one cause. Although unpleasant at any age, the consequences of dizziness and vertigo are a particular problem for older patients. Patients with frailty are at significant risk of falling with consequent fractures; their fear of moving and falling often significantly decreases their ability to do daily activities. In addition to treatment of specific causes, older patients with dizziness or vertigo may benefit from physical therapy and exercises to strengthen muscles and help maintain independent ambulation as long as possible. 