Dizziness is common enough in all adults. But it may happen more often in older people and for different reasons. Understanding dizziness may help to stop it from happening.
Why and How It Happens
The brain gets signals from all over the body. The signals come from eyes, structures in inner ear, and nerves all over the body. They then get processed through areas of the brain called the brainstem and cerebellum. These signals help the brain understand where the body is in space. Dizziness occurs when the signals are damaged or if the brain can not read them right. It can be caused by passing issues like dehydration or longer term medical issues. Older adults are more likely to have issues that can lead to dizziness. This includes changes to inner ear, eyesight, and conditions like diabetes. Older adults can also have changes in blood flow to the brain. This may affect how the brain works.
Many Different Factors
Many older adults may have one or more conditions that can be causing dizziness. Some medicine may also cause dizziness, and older folks are more likely to be on one or more medicines. This can not only increase the risk of dizziness in older adults but also make it harder to find a cause.
Some conditions that can increase the risk of dizziness include:
- History of heart attack or stroke
- History of head trauma or whiplash
- Alcohol use disorders
- High intake of caffeine
Dizziness that is due to vertigo may be caused by:
- Infections or problems with blood flow in inner ear, brain stem, or cerebellum
- Certain neurologic disorders
Blood flow issues can cause dizziness due to lightheadedness which can happen with:
- Poor circulation, due to hardening of the arteries
- Decreased blood pressure
- Poor heart function
- A drop in blood pressure when first standing up, a condition called orthostatic hypotension
Many medicines 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 disease, muscle relaxants, and tricyclic antidepressants
- Erectile dysfunction medications—sildenafil and drugs to relieve cramps in the bladder
Dizziness that happens at a specific time of day may be due to a medicine.
Do Not Suffer in Silence
Dizziness is not a normal part of aging. It is a symptom that somethign is not working right. If you are having dizzy spells, talk to your doctor. Keep track of the details. Note when it occurs and what you were doing when you felt dizzy. Describe how you felt and if you were taking any medicine. A little work between you and your doctor may help get the dizziness under control.
It is important to note that there is a difference between vertigo and dizziness. Vertigo refers to a sensation of motion when you are still. Dizziness refers to less specific symptoms, such as lack of balance and lightheadedness, that may also include vertigo. This difference can be important when you are looking for treatment.
Family Doctor—American Academy of Family Physicians
Vestibular Disorders Association
The College of Family Physicians of Canada
Dizziness—differential diagnosis. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T360974/Dizziness-differential-diagnosis. Updated March 19, 2018. Accessed October 1, 2018.
Dizziness and motion sickness. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/content/dizziness-and-motion-sickness. Accessed October 1, 2018.
Maarsingh OR, Dros J, Schellevis FG, et al. Causes of persistent dizziness in elderly patients in primary care. Ann Fam Med. 2010;8(3):196-205. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866716/.
Muncie HL, Sirmans SM, James E. Dizziness: approach to evaluation and management. Am Fam Physician. 2017;95(3):154-162.
Last reviewed August 2018 by EBSCO Medical Review Board Michael Woods, MD, FAAP Last Updated: 10/1/2018