Dizziness in Elderly: Causes and Solutions

My mother often experiences dizziness?

Hello, Doctor: My mother has been experiencing dizziness lately, often feeling as if there is an earthquake.
She feels unsteady when there are movements with elevation changes.
Recently, during these dizzy episodes, she also experiences tingling in her scalp and a sensation similar to "kā-lūn-sǒng" (Taiwanese).
Could you please take the time to respond? Thank you!

Shi Wan Duo Yun, 30~39 year old female. Ask Date: 2010/04/08

Dr. Jiang Hezhou reply Neurology

Dear Mr.
Hundred Thousand Clouds,
Your daughter is experiencing symptoms of dizziness and a sense of imbalance, which are common in middle-aged and older adults.
The causes can be numerous, and it is important to first establish a diagnosis.
Therefore, during the outpatient visit, we should clarify how long these symptoms have been occurring.
Did they start suddenly or develop gradually? Are they worsening over time or remaining stable? Are they episodic or continuous? Is there a sensation of spinning (vertigo)? Is there any nausea or vomiting? Are there any accompanying symptoms? In what situations do these symptoms occur or worsen? What measures can alleviate the symptoms? How does the tingling sensation in the scalp relate to the symptoms of "ga-lun-sun"?
After conducting a thorough history, physical examination, and neurological assessment, we can arrive at a preliminary diagnosis and proceed with treatment.
Thank you for your attention.
Changhua Hospital

Reply Date: 2010/04/08

More Info

Dizziness in the elderly can be a complex issue, often stemming from a variety of causes. Understanding the underlying factors is crucial for effective management and treatment. In your mother's case, the symptoms of dizziness, feelings of instability, and scalp tingling could indicate several potential medical conditions.

Causes of Dizziness in the Elderly
1. Vestibular Disorders: The vestibular system, which helps control balance, can deteriorate with age. Conditions like benign paroxysmal positional vertigo (BPPV) can cause sudden dizziness when changing positions.

2. Cardiovascular Issues: Orthostatic hypotension, where blood pressure drops significantly upon standing, can lead to dizziness. This is particularly common in older adults and can be exacerbated by medications.

3. Neurological Conditions: Conditions such as Parkinson’s disease, multiple sclerosis, or transient ischemic attacks (TIAs) can present with dizziness and balance issues.

4. Medication Side Effects: Many elderly individuals take multiple medications, which can interact and lead to dizziness. Common culprits include antihypertensives, sedatives, and certain antidepressants.

5. Dehydration and Nutritional Deficiencies: Dehydration can lead to dizziness, especially if fluid intake is low. Additionally, deficiencies in vitamins such as B12 or folate can affect neurological function and balance.

6. Anxiety and Psychological Factors: Anxiety can manifest physically, leading to sensations of dizziness and instability. The feeling of "earthquakes" or ground instability may be linked to anxiety or panic attacks.

Solutions and Management
1. Medical Evaluation: It is essential for your mother to undergo a thorough medical evaluation. This should include a review of her medical history, a physical examination, and possibly tests such as blood pressure measurements in different positions, blood tests, or imaging studies to rule out serious conditions.

2. Medication Review: A healthcare provider should review all medications your mother is taking to identify any that could be contributing to her dizziness. Adjustments or alternatives may be necessary.

3. Vestibular Rehabilitation: If a vestibular disorder is diagnosed, physical therapy focusing on balance and coordination can be beneficial. Specific exercises can help retrain the brain to compensate for balance issues.

4. Hydration and Nutrition: Ensuring adequate hydration and a balanced diet rich in essential vitamins and minerals can help improve overall health and reduce dizziness. Encourage her to drink plenty of fluids and eat a variety of foods.

5. Fall Prevention: Since dizziness can lead to falls, it is crucial to implement safety measures at home. This includes removing tripping hazards, using non-slip mats, and ensuring adequate lighting.

6. Anxiety Management: If anxiety is a contributing factor, cognitive-behavioral therapy (CBT) or relaxation techniques may help. Mindfulness practices and breathing exercises can also be beneficial.

7. Follow-Up Care: Regular follow-ups with healthcare providers are essential to monitor her condition and adjust treatment as necessary.

In conclusion, dizziness in the elderly is a multifaceted issue that requires careful evaluation and management. By addressing the underlying causes and implementing appropriate interventions, it is possible to improve your mother's quality of life and reduce her symptoms. If her dizziness persists or worsens, seeking immediate medical attention is crucial to rule out any serious underlying conditions.

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