Dizziness In Old Age

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Dizziness In Old Age
Dizziness In Old Age
Video: Dizziness In Old Age
Video: Dizziness and Vertigo, Part I - Research on Aging 2023, February

Dizziness in old age

Many older people suffer from dizziness. Around 30 percent of those over 70 are affected. Prolonged or recurring dizziness makes walking unsteady and is often associated with a fear of falling.

Dizziness is not a normal consequence of aging, but usually a sign that an organ disorder or disease is present. Often several disorders exist at the same time in old age, which makes diagnosis difficult. If the cause can be determined, dizziness is usually treatable.


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  • ">How is vertigo diagnosed and treated?


  • What are the causes of dizziness?
  • Whom can I ask?
  • How are the costs going to be covered?


How is vertigo diagnosed and treated?

In order to determine the cause of the dizziness, the doctor takes the anamnesis and asks about the type of vertigo symptoms and the accompanying circumstances:

  • How does the dizziness occur? (E.g. vertigo, vertigo, vertigo only when walking or standing or diffuse vertigo.)
  • How long does the dizziness last? (E.g. several days, hours or seconds.)
  • What causes the dizziness? (E.g. changing the position of the head, getting up after lying down, fear-inducing situations, taking medication, alcohol, etc.)
  • Are there any accompanying symptoms? (E.g. hearing disorders, gait disorders, migraines, neurological failures, anxiety, etc.)

The doctor will then conduct a clinical examination with various tests to obtain further information on the cause of the vertigo. The doctor may prescribe further examinations (e.g. MRI).

Therapy depends on the underlying condition. The doctor can treat acute complaints such as dizziness, balance disorders or nausea with short-term medication.

What are the causes of dizziness?

Dizziness can indicate a weakness or disease of the auditory and balance organs, the cardiovascular system or the blood vessels, the nerves or the brain. Fears, psychological problems or adverse effects from medication are also possible.

The most common forms or causes of dizziness in old age are:

Benign positional vertigo

Short attacks of dizziness when changing the position of the head, e.g. turning over or standing up in bed, are typical. They can cause nausea and vomiting. The cause are so-called ear stones (otoconia) that slide into the semicircular canals of the equilibrium organ. The ear stones usually support balance and spatial awareness. Possible causes for the slipping of the ear stones are age-related degradation processes, vibrations of the head or a disease of the inner ear.

This common form of dizziness is easily treatable. The aim of treatment is to remove the slipped ear stone from the semicircular canal. To do this, the doctor performs specific movements with the patient's head, so-called positioning maneuvers. The symptoms of dizziness usually go away on their own after a few weeks.

Bilateral vestibulopathy

The bilateral disruption of the organs of balance causes vertigo, which usually occurs when walking in the dark and on uneven ground. A temporarily blurred view is also typical. Vestibulopathy can have various causes. These include the undesirable effects of drugs (e.g. aminoglycosides), Menière's disease, polyneuropathies or cerebellar disorders. In around 50 percent of diagnosed cases, the doctor cannot determine a specific cause. The treatment is carried out through physiotherapy with targeted balance training as well as gait and stance training.

Central dizziness

Central dizziness can be triggered by damage to or diseases of the cerebellum, eg lesions, circulatory disorders, neurodegenerative diseases, tumors, infections, drug overdoses, etc. The dizzy spells can last only a few seconds or several days. They are typically accompanied by symptoms such as impaired vision, speech, swallowing or movement. Symptoms of paralysis can also occur. A doctor should be consulted quickly if a central disorder is suspected.

Orthostatic dizziness

The brain and the organ of equilibrium are not adequately supplied with blood. Temporary dizziness, which mainly occurs after getting up from sitting or lying down, is typical. One cause is low blood pressure (hypotension). Hypotension can also be an undesirable effect of medication. For the therapy, the doctor can prescribe the medication-based regulation of blood pressure and control the effect accordingly. Regular exercise and endurance training also improve the functioning of the circulatory system.

Vestibular migraines

Migraines can cause vertigo, which is also accompanied by nausea, vomiting and unsteady gait. The dizziness attacks can last anywhere from a few minutes to several days. Only half of the patients with vestibular migraines also suffer from headaches. When making the diagnosis, the doctor will also clarify other symptoms of a migraine.

Psychogenic dizziness

Diffuse dizziness triggered by certain situations is typical. In addition, there can be fear, palpitations, anxiety, tremors or sweating. Often the patients are very limited in everyday life by the fear of falling. Psychotherapy is an important therapeutic measure. It can be supplemented by drug treatment with antidepressants and physiotherapy training.

Whom can I ask?

For the treatment of dizziness, you can contact your family doctor or a specialist, e.g. for internal medicine (additional field of geriatrics), neurology or ear, nose and throat medicine.

How are the costs going to be covered?

All necessary and appropriate diagnostic and therapeutic measures are taken over by the health insurance carriers. Your doctor will generally settle accounts directly with your health insurance provider. However, you may have to pay a deductible with certain health insurance providers (e.g. BVAEB, SVS, SVS, BVAEB). However, you can also use a doctor of your choice (ie doctor without a health insurance contract). For more information, see Costs and Deductibles.

For certain examinations (e.g. MRI), a doctor's approval may be required. In the case of certain non-drug treatments (e.g. physical therapy), approval from the health insurance provider may be required - in some cases only when a certain level is reached. For certain services (e.g. inpatient stays, aids and medical aids) - depending on the health insurance provider - patient co-payments are provided. Medical aids must first be prescribed by the doctor. Most health insurance providers provide for a permit, sometimes depending on the type of medical aid.

The prescription fee has to be paid for medication on a “prescription”. For information on the respective provisions, please contact your health insurance provider, which you can find on the social security website.

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