Dizziness as We Age

Caregiver Corner
By Jennifer Beach

Gail is 73, an avid walker and very engaged with house projects, her circle of friends, volunteer work and her love of reading. Over the years, she has had various health issues to manage (a knee replacement, a few bouts of colitis and occasional sleeplessness).

Gail feels fortunate because, overall, she enjoys good health… until last week, when she was in the bathroom, stood up and felt dizzy; so dizzy she started throwing up. She was sitting on the bathroom floor, sweating, frightened and unable to see clearly. Thankfully, she had her cell phone within reach, was able to lay flat on her back and call 911.  

Dizziness in older adults is not uncommon and may be a result of many things, including:

1. Cardiovascular Issues can reduce the heart’s ability to pump blood throughout the body, causing dizziness to occur. Sudden drops in blood pressure when moving from one position to another can occur (Orthostatic Hypotension) and may cause dizziness. Additionally, conditions that result in poor blood circulation and inadequate blood flow to the brain can cause dizziness. These may include heart attack, heart arrhythmia, cardiomyopathy and stroke.
2. Medications can have side effects that contribute to feeling dizzy. The most common are diuretics, antiseizure meds, antidepressants, tranquilizers, sedatives and medications to lower blood pressure.
3. Dehydration: A loss of fluids can cause dizziness and is all too common in older adults. As we age, our total body fluid declines and our thirst response changes, leaving us feeling not as thirsty. Changes in our kidney, brain and bowel functions all contribute to potential dehydration, as well.
4. Low iron (anemia): Low iron in our blood reduces the amount of oxygen in our body. Along with dizziness, people experience weakness, fatigue and pale skin.
   
5. Hypoglycemia (low blood sugar): Symptoms of low blood sugar include dizziness, confusion, sweating and anxiety. Low blood sugar is most common in people with diabetes.
   
6. Vertigo is a vestibular, or balance, disorder that causes short periods of dizziness. It’s often described as a feeling of spinning. The most common type of vertigo is benign paroxysmal positional vertigo (BPPV). A sudden change of your head’s position can trigger it. In older people, going from a lying down position to standing up may trigger BPPV. It can also be caused by a variety of other things, including prolonged bedrest, alcohol and ear infection, to name a few.

The treatment for dizziness in older adults depends on the underlying cause. Discuss this with your medical provider and review all the potential factors that may be contributing to episodes of dizziness to find the best treatment. Treatments may include:

• Vestibular Rehabilitation: Physical therapy and balance techniques address dizziness caused by issues in the inner ear

• Canalith repositioning: Head positioning movements with a trained  professional can help relieve BPPV (benign paroxysmal positional vertigo (BPPV) 

• Medications: Certain medications can help with dizziness, including: 

antihistamines

anticholinergics

anti-anxiety medications (benzodiazepines)

preventive migraine medications

Gail was taken to the hospital and after several tests it was determined she had loose calcium-carbonate crystals, called otoconia, within the fluid-filled semicircular canals of her inner ear. This resulted in BPPV and she was diagnosed and treated for vertigo. Gail had never experienced anything like it before, and why it occurred at all she may never know. We do know that women over 50 are more likely to experience vertigo than men. Once treated, Gail was back to her usual self, walking, going out with friends, and enjoying her life again.  

Dizziness in older adults can result from a variety of causes and should be discussed with a medical provider, not only to minimize a serious injury from a fall, but to potentially identify other treatable medical conditions.