Dizziness in Seniors: Blood Tests and Beyond

Q: Dizziness in Seniors: Blood Tests and Beyond

JERRY： Hello! Your mother is 61 years old and has been experiencing dizziness frequently over the past few years. <br>She has undergone several blood tests at the hospital, all of which have returned normal results. <br>I would like to know if there are any other symptoms, such a

Dizziness - Blood Test Examination

Hello Dr.
Ouyang, my mother is 61 years old this year.
In recent years, she has frequently experienced dizziness.
She has been to the hospital for examinations several times, but they all said there was no problem, and each time they only performed blood tests.
I would like to ask the doctor, what are the possible symptoms that could lead to dizziness? Is it correct to only do blood tests each time? Are there other examinations that need to be done?

JERRY, 30~39 year old female. Ask Date: 2012/04/10

Dr. Ouyang Wenzhen reply Geriatrics

JERRY: Hello! Your mother is 61 years old and has been experiencing dizziness frequently over the past few years.
She has undergone several blood tests at the hospital, all of which have returned normal results.
I would like to know if there are any other symptoms, such as poor memory, anxiety, mood disturbances, or agitation.
Has she experienced weakness in one side of her body or had a stroke? If she does not have any of the aforementioned issues, the most likely causes of her dizziness could be related to problems with the vestibular nerve (the 8th cranial nerve, which is associated with the auditory nerve) and inner ear balance, or low blood pressure.
I recommend consulting an otolaryngologist or a neurologist for diagnosis and treatment.
If she has already had blood tests done 2-3 times (which typically assess for conditions like hypoglycemia, hyperglycemia, hyperlipidemia, or nutritional deficiencies) without any progress, it would be advisable to visit a larger hospital or a specialized facility with neurology and psychiatry departments for further evaluation, such as EEG, CT scan, or MRI of the brain.

If she has symptoms of poor memory, it could indicate a precursor to dementia or existing dementia.
A comprehensive and detailed memory assessment, EEG, brain imaging (CT or MRI), ECG, and complete blood tests related to dementia—such as folate, B12, calcium levels, thyroid function tests, and syphilis serology—should be conducted at a facility with neurology and psychiatry services.

If she experiences anxiety, mood disturbances, or agitation, it may suggest depression or anxiety disorders.
In addition to the memory assessment, EEG, brain imaging, ECG, and dementia-related blood tests mentioned earlier, she should undergo a thorough evaluation and psychological testing at a psychiatric facility.

If she has experienced weakness in one side of her body or has had a stroke, this could indicate dizziness related to cerebral blood flow or stroke.
In addition to the previously mentioned assessments, a carotid artery flow study should be performed.

Wishing you peace and joy,
Ouyang Wenzhen
May 3, 2012, at the Chianan Health Promotion Center, Department of Health

Reply Date: 2012/04/10

More Info

Dizziness in seniors can be a complex issue, often requiring a multifaceted approach to diagnosis and management. Your concern about your mother's recurrent dizziness is valid, especially considering her age. While blood tests are a common initial step in evaluating dizziness, they may not always provide a complete picture of the underlying causes.
Dizziness can stem from various sources, and understanding these potential causes is crucial. Here are some common reasons for dizziness in older adults:
1. Vestibular Disorders: The vestibular system, which helps control balance, can be affected by age-related changes, inner ear infections, or conditions like Benign Paroxysmal Positional Vertigo (BPPV). BPPV is characterized by brief episodes of dizziness triggered by changes in head position.

2. Cardiovascular Issues: Conditions such as orthostatic hypotension (a drop in blood pressure when standing up), arrhythmias, or heart disease can lead to dizziness. Blood tests can help assess overall cardiovascular health, but additional tests like an electrocardiogram (ECG) or echocardiogram may be necessary.

3. Neurological Conditions: Dizziness can be a symptom of neurological disorders such as Parkinson’s disease, multiple sclerosis, or transient ischemic attacks (TIAs). A neurological evaluation, including imaging studies like MRI or CT scans, may be warranted if there are concerns about these conditions.

4. Medication Side Effects: Many medications can cause dizziness as a side effect, especially in older adults who may be taking multiple prescriptions. A review of her current medications with her healthcare provider is essential to rule out this possibility.

5. Anemia or Blood Disorders: Blood tests can help identify anemia, which can cause dizziness due to reduced oxygen delivery to the brain. If her blood tests show low hemoglobin or hematocrit levels, further evaluation may be needed.

6. Dehydration or Electrolyte Imbalance: Older adults are at higher risk for dehydration, which can lead to dizziness. Blood tests can assess electrolyte levels, and ensuring adequate hydration is crucial.

7. Psychological Factors: Anxiety and depression can also manifest as dizziness. A mental health evaluation may be beneficial if psychological factors are suspected.

Given that your mother has undergone multiple blood tests without a definitive diagnosis, it may be time to consider additional evaluations. While blood tests are essential, they should be part of a broader diagnostic approach. Here are some recommendations:
- Comprehensive Evaluation: A thorough assessment by a healthcare provider specializing in geriatric medicine or neurology may provide insights into her condition. This could include a detailed history, physical examination, and specific tests based on her symptoms.

- Vestibular Testing: If vestibular disorders are suspected, specialized tests such as videonystagmography (VNG) or posturography can help assess balance function.

- Imaging Studies: If neurological causes are a concern, imaging studies like MRI or CT scans can help rule out structural issues in the brain.

- Cardiovascular Assessment: If cardiovascular issues are suspected, further tests such as an ECG or Holter monitor may be appropriate.

- Medication Review: A thorough review of her medications with her healthcare provider can help identify any that may contribute to her dizziness.

In conclusion, while blood tests are a valuable tool in diagnosing the cause of dizziness, they should be complemented by a comprehensive evaluation that considers various potential causes. Encouraging your mother to discuss her symptoms in detail with her healthcare provider can lead to a more accurate diagnosis and effective management plan.

Similar Q&A

Understanding Dizziness in Elderly Patients: When to Seek Medical Help

Doctor: Hello! My father is 88 years old with a blood pressure of 145/105 and a blood sugar level of 97/210 (he has been taking antihypertensive medication and medication for high blood sugar from Miaoli Provincial Hospital for a long time). However, he has been experiencing freq...

Dr. Ouyang Wenzhen reply Geriatrics
Hello Tian Tian, your father has a history of stroke, as well as hypertension and diabetes, which indeed places him at high risk for recurrent stroke or vascular dementia. Currently, your father is experiencing dizziness, and the first consideration should be "orthostatic hy...

Understanding Chronic Dizziness in Seniors: Causes and Treatment Options

Hello Dr. Huang: My mother is currently 75 years old and has been experiencing dizziness since she was in her thirties. Her symptoms include a feeling of unsteadiness while walking. She has consulted with an ear specialist and has taken many medications for dizziness, but nothing...

Dr. Huang Yongquan reply Neurology
Hello: In response to your question. Based on your description, it seems that this condition has been occurring since your youth and continues to present with dizziness. If the dizziness is intermittent and accompanied by nausea and vomiting, the most common issue is related to t...

Understanding Fluctuating Blood Pressure and Dizziness in Older Adults

Hello, doctor. I would like to ask about my mother, who is 63 years old. She has been experiencing long-term dizziness, and when she stands for too long, she also feels dizzy and needs to lie down to feel some relief. Additionally, when she consumes salty or sweet foods, her bloo...

Dr. Jiang Junyi reply Neurology
Hello, based on your description, there are many factors that can cause symptoms of dizziness, such as anemia, autonomic nervous system dysfunction, and inner ear imbalance. Your symptoms appear after standing for a while, so it is essential to first rule out symptoms caused by l...

Understanding the Link Between Hypertension, Dizziness, and Headaches

Hello, I am inquiring on behalf of my mother, who is 61 years old. With the aging process, she has developed hypertension and experiences occasional dizziness and blurred vision, especially in the evenings when she feels extremely fatigued by 9 PM. She had a check-up at a major h...

Dr. Lin Changqi reply Cardiology
A 61-year-old patient is not considered to be in an older age group for cardiology. Based on your description, your mother may have some minor circulatory issues or occasional elevated blood pressure. Since the information provided does not include diastolic pressure or other dat...