• Combating Dizziness in Older Adults

    IMAGE Dizziness is common in all adults, but there are special reasons why older people may become dizzy. Understanding why it happens is the first step towards addressing dizziness.

    Why and How It Happens

    Dizziness occurs when the brain does not receive reliable messages from senses about the body's position or motion in space. Medical conditions, such as diabetes, can cause loss of accurate vision, hearing, inner ear function, and peripheral nerve sensation resulting in these unreliable messages.
    Older people are especially vulnerable because there are more things that can interact to produce conditions leading to dizziness. For example, excessively low blood pressure may result from medications used to lower your hypertension or treat prostate problems. Low blood pressure may make you dizzy when you stand up.

    Many Different Factors

    There are a range of conditions that can cause dizziness. Finding the cause can be frustrating to doctors and their patients. However, the cause must be understood in order to treat it.
    Some conditions that can increase the risk of dizziness include:
    One of the most common conditions confused with dizziness is known as vertigo. It is important to note that there is a difference between vertigo and dizziness. Vertigo refers to a sensation of motion when you are resting; dizziness refers to less specific symptoms, such as lack of balance and lightheadedness. This difference can be an important factor in diagnosing the problem.
    Another reason for dizziness can be attributed to the circulatory system, which supplies the brain and inner ear with blood and oxygen. Poor circulation, due to hardening of the arteries, decreased blood pressure, or poor heart function, can all result in dizziness. A drop in blood pressure when first standing up, a condition called postural hypotension, triggers many episodes of dizziness. Feeling anxious can also cause dizziness. Certain neurologic disorders can bring on episodes of dizziness as well.
    Many medications may cause dizziness. Some examples include:
    • Heart —alpha blockers, beta blockers, angiotensin-converting enzyme inhibitors, diuretics, and nitrates
    • Medications that affect the central nervous system—antipsychotics, opioids, drugs to treat Parkinson's disease, muscle relaxants, and tricyclic antidepressants
    • Erectile dysfunction medications—sildenafil and drugs to relieve cramps in the bladder
    If you notice that the dizziness is more significant during a specific time of day or after trying a new medication, it may be that the drug is to blame.

    Do Not Suffer in Silence

    Dizziness is not a normal part of aging. It is a symptom that the body is not functioning properly. If you are having symptoms, talk to your doctor. A diary chronicling your activities, medications, and descriptions of dizzy episodes often help doctors narrow the possibilities.

    RESOURCES

    American Academy of Family Physicians http://www.familydoctor.org

    Vestibular Disorders Association http://www.vestibular.org

    CANADIAN RESOURCES

    Canadian Medical Association http://www.cma.ca

    Health Canada http://www.hc-sc.gc.ca

    References

    Dizziness—differential diagnosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated December 16, 2011. Accessed October 14, 2013.

    Dizziness and motion sickness. American Academy of Otolaryngology website. Available at: http://www.entnet.org/healthinformation/dizzinessmotionsickness.cfm . Updated December 2010. Accessed October 14, 2013.

    Drachman D. A 69-year-old man with chronic dizziness. JAMA. 1998; 280:2111-18.

    Grimby A, et al. Health-related quality of life and dizziness in old age. Gerontology. 1995;41: 286-98.

    Post R, Dickerson L. Dizziness: a diagnostic approach. Am Fam Physician. 2010 Aug 15;82(4):361-68. Available at: http://www.aafp.org/afp/2010/0815/p361.html. Accessed October 14, 2013.

    Tinetti ME, et al. Dizziness among older adults: a possible geriatric syndrome. Ann Intern Med. 2000;132:337-34.

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