Combating Dizziness in Older Adults
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. It can also occur if the brain does not get enough blood flow. This can happen due to circulation problems or dehydration
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 regulate high blood pressure
or treat prostate problems. Low blood pressure may make you dizzy when you stand up.
It is important to note that there is a difference between vertigo
. 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 an important factor in diagnosing the problem.
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:
Dizziness that is due to vertigo can result from problems with the inner ear or the part of the brain responsible with balance. This can result from infections or problems with blood flow. Certain neurologic disorders can bring on episodes of dizziness as well.
Dizziness that is due to lightheadedness can be attributed to the circulatory system, which supplies the brain with blood and oxygen. Poor circulation, due to hardening of the arteries
, decreased blood pressure, or poor heart function, can all result in reduced blood flow and lightheadedness. A drop in blood pressure when first standing up, a condition called orthostatic hypotension
, triggers many episodes of lightheadedness. Feeling anxious can also cause dizziness.
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 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
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.
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 February 7, 2017. Accessed August 11, 2017.
Dizziness and motion sickness. American Academy of Otolaryngology—Head and Neck Surgery website. Available at:
Accessed August 11, 2017.
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:
Muncie HL, Sirmans SM, James E. Dizziness: approach to evaluation and management. Am Fam Physician. 2017;95(3):154-162.