Vertigo is a sensation of spinning or feeling that the surroundings are moving when they are not. This disorienting experience can also manifest as a swaying movement, often accompanied by nausea, vomiting, or difficulty walking. This article explores the relationship between age and vertigo, addressing whether it tends to worsen with age.
The Age-Vertigo Connection
Vertigo often becomes more common and severe as individuals age. This increased prevalence is largely due to the natural decline in the vestibular system, which includes the inner ear balance organs, nerves, and brain processing centers. A decrease in nerve cells and hair cells within the vestibular system, along with diminished blood flow to the inner ear, contributes to this decline.
Beyond the inner ear, age-related changes in vision and proprioception, the body’s sense of its position in space, further contribute to overall balance issues. These sensory declines can exacerbate feelings of unsteadiness and make vertigo symptoms more pronounced. Older adults are also more likely to be taking multiple medications, a practice known as polypharmacy, where certain drugs can cause dizziness or vertigo as a side effect.
The increased likelihood of underlying health conditions in older adults can also contribute to vertigo episodes. Cardiovascular issues, for instance, can affect blood flow to the brain and inner ear, impacting balance. This combination of physiological changes, medication effects, and other health concerns explains why vertigo often presents more frequently and intensely in later life.
Common Vertigo Conditions in Older Adults
Several types of vertigo are more prevalent among older adults due to age-related physiological changes. Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of vertigo in this age group. It occurs when tiny calcium carbonate crystals, called otoconia, dislodge from their normal position in the inner ear and migrate into the semicircular canals, triggering brief but intense spinning sensations with head movements. The crystals in the inner ear become less dense and are replaced more slowly with increasing age, making BPPV more frequent.
Vestibular migraine, while not exclusive to older adults, can present differently in this population. This condition involves episodes of dizziness or vertigo, often accompanied by headache, though the headache component may be less prominent in older individuals. Another condition, vestibular hypofunction, also known as age-related vestibulopathy, describes a general decline in inner ear function that leads to chronic imbalance and persistent vertigo. This decline can involve the loss of function on both sides of the balance system, known as bilateral vestibulopathy.
Orthostatic hypotension is a common condition in older adults where blood pressure drops significantly upon standing, causing lightheadedness and sometimes a sensation akin to vertigo. This can lead to brief dizzy spells when moving from a sitting or lying position to standing. Lastly, cervicogenic dizziness can arise from age-related changes in the neck, such as arthritis, which sometimes contribute to balance issues and vertigo-like symptoms by affecting sensory input from the neck to the brain.
Strategies for Managing Vertigo in Later Life
Managing vertigo in older adults begins with a thorough medical evaluation, which considers any existing health conditions and current medications. Specialized tests, such as audiometry or videonystagmography, may be used to assess inner ear function and help pinpoint the cause of vertigo. This comprehensive diagnostic approach helps to create an individualized treatment plan.
One important treatment approach involves reviewing and adjusting medications that might be contributing to vertigo symptoms. Vestibular Rehabilitation Therapy (VRT) is a highly beneficial treatment, involving targeted exercises that help the brain compensate for inner ear deficits. VRT aims to improve balance, reduce dizziness, and enhance overall mobility through specific head movements, eye exercises, and gait training.
For BPPV, the Epley Maneuver is a very effective physical therapy technique. It involves a series of specific head movements designed to reposition the displaced ear crystals back to their correct location in the inner ear. Lifestyle adjustments also play a role in managing vertigo. These include maintaining adequate hydration, avoiding sudden head movements, and ensuring home safety to prevent falls. Practices like Tai Chi and yoga can improve balance and reduce dizziness, while elevating the head slightly during sleep may help some individuals. It is important to seek medical attention if vertigo is sudden and severe, or if it is accompanied by other neurological symptoms like double vision, speech difficulties, or limb weakness.