As we age, it is more and more common for elderly people to experience periods of vertigo. Or extreme dizziness emanating from a variety of frequent causes.
According to a study published in 2014, approximately twenty-five percent of individuals over the age of about seventy-two years of age regularly report that they have experienced episodes of vertigo-like symptoms including feeling either dizzy, unbalanced, or unsteady.
This, of course, leads to an increased risk of a traumatic fall. Plus, the possibility of ending up in the hospital, bedridden with a disastrous fractured hip or leg. Read on to learn more about what causes vertigo in elderly individuals and how it is treated.
Vertigo: What Exactly is It?
By definition, Vertigo refers to the sensation of dizziness experienced with the major symptom being a feeling that the external environment around you is spinning when you are standing or sitting at rest or rising quickly.
It certain hypotheses it’s an experience of spinning and outside environment is really self-motion. After all, the eyes send signals to the brain on how we are moving through space – but what makes us feel like we are moving when we are not?
Causes of Vertigo
To answer the question, what causes vertigo in elderly people? It is important to look at the most common causes of vertigo in the senior age group. These causes include benign paroxysmal positional vertigo, dizziness due to arthritic degeneration of the spine, dizziness secondary to postural or orthostatic hypotension, Meniere’s Disease, Vestibular Neuritis, the side effects of certain medications, and untreated mental health conditions such as anxiety.
Benign Paroxysmal Positional Vertigo
Benign Paroxysmal Positional Vertigo (BPPV), which is the commonest cause of vertigo in seniors, refers to a condition whereby very small calcium crystals (otoconia) dislodge, usually present on the utricle (a sensory organ in the inner ear). When this occurs, the otoconia flows into the spaces in the inner ear filled with fluid, such as the semi-circular canals (that are responsible for sensing movements of the head).
When a person moves their head rapidly, the otoconia drift to the lowest parts of the semi-circular canals, leading to a flow of fluid. This fluid motion then causes stimulation of the 8th cranial nerve (vestibular nerve) that controls balance, which leads to the symptoms of vertigo.
Dizziness due to Degeneration of the Spine
Another common cause of vertigo in the elderly is age-related progressive degenerative arthritis (osteoarthritis) of the spinal vertebra in the neck (cervical spondylosis). As the spinal column degenerates further, this leads to increased pressure on spinal nerves, spinal arteries, and potentially even the spinal cord. Any one of these conditions can then cause vertigo in seniors.
Dizziness due to Postural or Orthostatic Hypotension
Postural hypotension, which is also called orthostatic hypotension, refers to the medical condition in which, when a person has low blood pressure (hypotension) rapidly changes from a sitting or lying position to a standing position, they become lightheaded and dizzy. Orthostatic hypotension is a common cause of vertigo in seniors over the age of 65 years old.
Meniere’s Disease refers to a condition of the inner ear that causes vertigo along with ringing in the ears and also occasional hearing loss. It is thought to occur due to a buildup of fluid in the inner ear that causes a buildup of pressure.
Vestibular neuritis is a cause of vertigo in the elderly that is due to a viral infection. It usually improves over a two to three month period. Vestibular neuritis usually causes nausea and vomiting as additional symptoms.
Side Effects of Medications
Side effects of the following medicines, when administered to the elderly, can also lead to vertigo. These medications include pain medicines such as codeine, certain antibiotics, anti-seizure medicines such as Phenytoin, certain anti-viral medications, fluid pills such as furosemide, and erectile dysfunction treatments like sildenafil.
Anxiety in seniors is a common condition and can often lead to vertigo. It can often accompany other mental health conditions such as panic disorder and depression. Elevated levels of stress in seniors have a positive correlation with the development of vertigo. It is thought that with increased stress, the body produces more of the hormone cortisol, which interferes with neurotransmission in the inner ear’s vestibular system, causing vertigo.
Symptoms of Vertigo to Look for in Elderly Loved Ones
There are many common symptoms of Vertigo to look for in elderly loved ones https://www.webmd.com/brain/vertigo-symptoms-causes-treatment. These include seeing them suddenly tilting over or stumbling and grabbing for something to grab onto as they are experiencing the room spinning around them. You might also notice that an elderly loved one may be swaying when walking. They might also suddenly start to feel nauseous and/or start vomiting.
You might also notice that your elderly loved one has a problem with their eyes jerking back and forward, also known as nystagmus, another indication of vertigo. They may also complain of having a headache, sweating, or experiencing hearing loss.
Another common symptom of Vertigo is tinnitus. Tinnitus is a ringing sound in your ear. (Or a buzzing, clicking, hissing, roaring, whistling sound.)
This symptom is often more difficult to establish. That said, tinnitus is also associated with hearing loss and may be accompanied by ear fullness and/or pain. So keep an eye out for is the complaint of tinnitus, especially accompanied by pain.
Treatment for Vertigo
Treatment for vertigo typically begins with something called canalith repositioning maneuvers. These maneuvers move the patient’s head in certain directions. The motions (hopefully) shift the otoconia out of the ear canals and into an inner ear chamber. Then, they’re reabsorbed back into the body.
Another treatment for vertigo includes balance therapy. A procedure in which patients conduct specific exercises and movements. Each exercise for the improvement of a person’s inner ear balance mechanism not as sensitive to motion.
If these maneuvers do not diminish vertigo, the next step may be to have a trial of treatment with medication. Medical treatment usually begins with treatment of nausea that accompanies vertigo with an anti-nausea medicine such as Reglan (metoclopramide). Additionally, antihistamines such as Meclizine (Antivert), help reduce the toxic spinning effect of vertigo.
In addition, the treatment of vestibular neuritis may require treatment with antibiotics.
And what if Antivert does not significantly reduce the symptoms of vertigo? A benzodiazepine tranquilizer such as Diazepam (Valium) or Lorazepam (Ativan) is a potential further treatment.