What causes dizziness in older adults?

Dizziness is common in older adults and has links to a higher risk of falls, disability, and an overall decline in health. It can have different causes, requiring a diagnosis to find the right treatment.

Dizziness is a general feeling of lightheadedness, weakness, or unsteadiness, sometimes with nausea, sweating, or confusion.

The sensation is common in older people. One 2021 study found that around half of participants over 79 years old experienced dizziness, while another 2022 study found that more than 60% of the subjects over age 75 experienced this symptom. However, because dizziness has many possible causes, it is not always easy to diagnose and treat.

The following article discusses the most common causes of dizziness in older adults, treatment options, and when dizziness is a sign of an emergency medical condition.

There are numerous potential causes of dizziness in older adults. Based on research from 2023, the following are common causes of vertigo, ranked by how common they are in older age:

That said, it’s important to clarify that the term “dizziness” is often used interchangeably with “vertigo.” Vertigo is a type of dizziness that feels like spinning or whirling, often with nausea, vomiting, and balance problems.

The above causes can contribute to dizziness specifically and to dizziness more broadly. Other potential causes include:

In rare cases, dizziness can signal an emergency like a stroke or heart attack.

Dizziness can feel different depending on the cause. Instead of one sensation, people often describe it in several ways. One of those ways is vertigo, but a person may also experience lightheadedness, a feeling of imbalance or being unsteady on their feet, feelings of floating, swimming, or having a heavy head.

People may experience these sensations when standing up quickly or turning their heads. When individuals live with a specific condition that triggers dizziness, they may experience it in a particular way. For example, with spinal stenosis, symptoms may include losing balance with the eyes closed or being unable to walk in a straight line.

One sign of dizziness in older adults, more specifically, can be an increase in the frequency of falls. This can have different causes, but dizziness can co-occur with falls. This is particularly important because falls are the top cause of injury in adults 65 and older. In the United States, about 1 in 4 older adults report a fall each year, and around 37% of these falls led to the need for medical treatment or a restriction of activities for at least 1 day.

Treatment for dizziness depends on its underlying cause. That said, various standard treatment options may include balance exercises (vestibular rehabilitation), medications such as water pills, antihistamines, anticholinergics, anti-anxiety drugs, or other medications, depending on the cause.

When dizziness relates to a new medication, the body often adjusts within a few weeks. However, a person needs to inform their doctor of all medications they are taking to avoid worsening symptoms.

In cases of BPPV, canalith repositioning maneuvers from a healthcare professional can often bring relief within just a few sessions. For severe cases of Meniere’s disease that do not respond to other treatments, doctors may recommend antibiotic injections into the inner ear to disable balance function, allowing the unaffected ear to compensate.

It is also important to reduce the risk of falls by staying physically active as much as possible, improving balance and strength, and taking safety precautions. These may include installing handrails, standing up slowly, and using assistive devices like a cane as needed.

Medicare Part B covers services that can help a person address balance-related symptoms, such as dizziness, which can help prevent falls. These include hearing and balance exams, bone mass measurements, yearly wellness visits, and the initial “Welcome to Medicare” visit.

Part B also covers physical and occupational therapy, acupuncture for chronic low back pain, caregiver training, and durable medical equipment (DME) like walkers, wheelchairs, and hospital beds.

Most preventive visits are free if the provider accepts assignment, while therapy and equipment usually require meeting the Part B deductible and paying the 20% coinsurance.

Dizziness is common in older adults and raises the risk of falls and injuries. This symptom can stem from inner ear disorders, heart or brain conditions, mood or vision problems, musculoskeletal issues, medications, or other health factors.

The treatment depends on the cause and may include exercises, medications, or procedures such as canalith repositioning for benign paroxysmal positional vertigo (BPPV).

Since falls are particularly dangerous in older people, staying active, rising slowly, and using safety measures such as handrails or canes can help reduce risk.