Causes of Vertigo in Elderly

Vertigo is the unsettling sensation that you or the room are spinning even when you are perfectly still. It can make standing, walking, or even rolling over in bed feel difficult. For older adults, vertigo deserves special attention because it is often caused by minor inner ear issues, but can be caused by more  serious medical conditions. Understanding the causes of vertigo in older individuals and how to treat them is key to maintaining safety and independence.

If you’re experiencing ongoing vertigo or dizziness, don’t wait to get help. You can become a patient to receive compassionate, personalized comprehensive primary care. Come visit one of Sage Health’s primary care clinics to experience the benefits of being a Sage Health patient. 

What Causes Vertigo in Older Adults?

Most common causes of vertigo in elderly

Vertigo develops when your body’s balance system is disrupted. That system involves both the inner ear and the brain, which work together to keep you stable and oriented. When either is affected, vertigo can result.

Inner Ear Causes of Vertigo in Elderly 

• Benign Paroxysmal Positional Vertigo (BPPV): Tiny calcium crystals inside the inner ear become dislodged and interfere with balance signals. This causes brief but intense spinning sensations triggered by head movements like lying down or looking up.
  
• Meniere’s Disease: Fluid buildup in the inner ear can cause vertigo, hearing loss, and ringing in the ears.
  
• Vestibular Neuritis or Labyrinthitis: Inflammation of the inner ear or nearby nerves can cause sudden, severe vertigo often after a viral infection.
  
• Acoustic Neuroma: A benign tumor on the nerve between the inner ear and brain that causes hearing loss, ringing, and imbalance.

Brain and Circulatory Causes of Vertigo in Elderly 

• Stroke or Transient Ischemic Attack (TIA): Reduced or blocked blood flow to the brain can cause vertigo, often with symptoms like weakness, vision changes, or slurred speech.
  
• Arterial Dissection: A tear in the wall of a neck artery can interrupt blood supply to the brain, causing vertigo and neck pain.
  
• Migraine-Related Vertigo: Some older adults experience vertigo during or between migraine attacks, even without a headache.
  
• Brain Tumors: Rarely, tumors pressing on balance centers can lead to vertigo or persistent dizziness.

Medication-Related Causes of Vertigo in Elderly

Certain medications can cause or worsen vertigo, especially those that affect the inner ear. These include:

• High doses of aspirin
  
• Loop diuretics (furosemide, bumetanide)
  
• Aminoglycoside antibiotics (gentamicin, tobramycin)
  
• Chemotherapy drugs (cisplatin, carboplatin)
  

If you experience new dizziness after starting a medication, discuss it with your doctor before stopping or changing your prescription.

Other Causes of Dizziness and Vertigo in Older Adults

Vertigo and dizziness often overlap, and not all dizziness comes from the inner ear. Additional causes of dizziness in seniors include:

• Low iron (anemia): When your blood lacks iron, oxygen levels drop, causing fatigue, weakness, pale skin, and dizziness.
  
• Low blood sugar (hypoglycemia): Common in people with diabetes, symptoms include confusion, sweating, shakiness, and lightheadedness.
  
• Carbon monoxide exposure: This rare but serious condition causes dizziness, nausea, chest pain, and confusion.
  
• Dehydration or overheating: Not drinking enough fluids, especially while on certain medications, can lead to dizziness and fainting.
  

Is Vertigo Common in Seniors?

Yes, vertigo and dizziness are very common among older adults. Age-related changes in the inner ear, vision, and blood flow increase the risk. Chronic conditions such as diabetes, heart disease, or arthritis can further impact balance. It’s essential to identify the cause early since vertigo significantly increases the risk of falls.

Symptoms of Vertigo in Elderly

Vertigo symptoms vary, but they commonly include:

• Spinning or tilting sensations
  
• Nausea or vomiting
  
• Difficulty walking or maintaining balance
  
• Blurred vision when turning the head
  
• Sensitivity to movement or light
  

Seek emergency care immediately if vertigo is accompanied by:

• Weakness or numbness in the face or limbs
  
• Trouble speaking
  
• Vision loss or double vision
  
• Severe headache or chest pain
  
• Recent head injury
  

Vertigo and Dizziness in Older Adults

Vertigo is a spinning sensation, while dizziness can also include feelings of faintness or imbalance. Seniors often experience both together, which can complicate diagnosis. Identifying when and how the symptoms occur, such as after standing up quickly or turning the head can help doctors pinpoint the cause.

Vertigo Exercises for Seniors

Once serious causes are ruled out, vertigo exercises can help improve balance and reduce spinning sensations:

• Epley Maneuver: A series of guided head and body movements to reposition inner ear crystals (for BPPV).
  
• Brandt-Daroff Exercises: Simple, repeated side-lying movements to retrain balance over time.
  
• Vestibular Rehabilitation Therapy: Physical therapy that strengthens balance and coordination.
  
• Safety Tips: Rise slowly, keep your home free of tripping hazards, and use support rails if needed.
  

How Is Dizziness Treated in Older Adults?

Treatment depends on the cause. Common options include:

• Medication adjustments: If dizziness is caused by new medication, your doctor may modify or replace it.
  
• Balance exercises: Vestibular rehabilitation helps strengthen your balance and reduce dizziness.
  
• Medications: Depending on the cause, treatment may include diuretics (for Meniere’s disease), antihistamines, anticholinergics, anti-anxiety medications, or migraine preventives.
  
• Canalith repositioning: Head movements guided by a clinician to relieve BPPV, often effective in one or two sessions.
  
• Injections: In severe Meniere’s cases, injections can disable balance signals in the affected ear so the other ear compensates.

Preventing Falls in Older Adults with Dizziness

The most serious consequence of dizziness in seniors is fall-related injury. Preventing falls starts with awareness and preparation:

• Stay physically active to maintain balance and muscle strength
  
• Use handrails and grab bars around the home
  
• Stand up slowly and keep a sturdy chair nearby
  
• Use a cane or walker if recommended
  
• Secure rugs and ensure good lighting
  
• Prepare meals while seated
  
• Use a reach stick for high shelves
  
• Wear non-slip, supportive shoes
  
• Talk to your doctor if new medications cause dizziness
  

When to Seek Medical Care

Persistent or worsening vertigo, especially with new neurological symptoms, should be evaluated immediately. Even mild dizziness that interferes with daily life deserves professional attention. To get comprehensive care, become a patient today and receive tailored support from experts who understand the unique needs of older adults. You can also visit one of Sage Health’s primary care clinics to learn more about the benefits of becoming a Sage Health patient. 

FAQs About Vertigo and Dizziness in the Elderly

Sources:

https://www.goodrx.com/conditions/vertigo/causes-of-vertigo-in-elderly

https://www.dispatchhealth.com/blog/reducing-dizziness-in-older-adults-with-vertigo

https://www.healthline.com/health/causes-of-dizziness-in-older-adults

https://pmc.ncbi.nlm.nih.gov/articles/PMC4306472