Dizziness is a symptom that can be difficult to describe and even mean different things to different people. More specific forms of dizziness include presyncopal light-headedness, vertigo, dysequilibrium and nonspecific dizziness. Presyncopal light-headedness is the feeling during an impending faint. Vertigo is the sensation of motion or spinning; dysequilibrium is the feeling of being off-balance or unsteady. Nonspecific dizzines may be vague, such as the feeling of floating, and does not fit the previous categories. The elderly may be more susceptible to the various forms of dizziness; identifying the cause is important in being able to treat it successfully.
Inner Ear Problems
The inner ear contains the vestibular system, responsible for helping to interpret spatial orientation at rest and while speeding up or slowing down. It also helps direct the eyes to one point during head movement. Degenerative changes with aging, such as osteoporosis, can affect the function of the inner ear and cause vertigo. In addition, the nerve that connects the inner ear to the brain, the vestibular nerve or cranial nerve VIII, can be damaged by medications, trauma such as surgery or falls, infections and low blood sugar.
Heart Problems
The elderly are more likely to have heart and circulatory problems. If blood is inadequately delivered to the brain, after a few seconds the person will feel like fainting; in other words they will experience presyncopal light-headedness. Rhythm problems such as atrial fibrillation or various heart blocks interfere with the coordination of contractions between the top and bottom chambers of the heart. This makes the pumping inefficient. In addition, the blood vessels in the elderly may not compensate as well to increase the blood blood pressure when it falls. This can occur when a person goes from lying down to sitting to standing. If the feeling of light-headedness occurs from sitting up or standing, it is referred to as orthostatic hypotension, and can be a sign of dehydration.
Nerve Problems
Nerve problems include those in the brain and in the rest of the body. Dizziness originating in the brain is termed "central dizziness." It generally happens from strokes in the cerebellum or brain stem, located at the back and bottom of the brain, respectively. Symptoms include illusions of motion, trouble walking and nausea.
Problems with nerves elsewhere in the body can lead to unsteadiness. Diminished sensation in the feet making it difficult to walk, or problems with nerves responsible for sensing where parts of the body are in relation to the others.
Medications
Certain medications may cause dizziness through some of the mechanisms already mentioned. They may interfere with nerve functioning or lower the blood pressure, for example. Seizure medications, blood pressure pills and sedatives are common causes of dizziness in the elderly. Some others include some antidepressants known as tricyclics, and the stomach acid drug cimetidine. The body may adjust to the medication over time, lessening the effects, or a physician may decide to change medications to eliminate the dizziness, reducing the chance for a fall or other accident in the elderly.
