Patient Daily Living

Fall Prevention for the Elderly

By Chris Iliades

Dizziness contributes to more than one-third of seniors over age 65 falling each year. It is important to understand the causes of dizziness and treat it accordingly.

According to the Centers for Disease Control and Prevention, more than one-third of seniors over age 65 fall each year. While broken bones from falling can lead to a loss of independence, more importantly, the data show that falling is actually the leading cause of injury-related death for seniors.

A recent study published in the journal Age and Ageing said dizziness is a common cause of falling and that seniors with vertigo – a sensation of feeling off balance - are the most likely to fall. The report states, “Dizziness is one of the commonest symptoms described by older people and is associated with balance disorders, functional decline, reduction in quality of life, and falls.” Fortunately, many of these falls can be prevented by recognizing and treating vertigo.

Understanding Dizziness and its Causes

Many seniors, including a majority over the age of 70, report feeling unsteady on their feet, lightheaded, or sometimes experiencing a false sense of movement. One-third between the ages of 65 and 75 report that dizziness or unsteadiness is a major concern that diminishes their quality of life.

It is important to know that not all dizziness symptoms are the same. Vertigo, for example, is defined as a sensation of whirling and loss of balance, associated particularly with looking down from a great height. It can make one feel like they are moving or spinning, or the room they’re in is. Vertigo is the most common type of dizziness associated with older people and the most likely to cause a fall. Fortunately, it can often be treated.

  • Positional vertigo. This condition, also called benign paroxysmal positional vertigo (BPPV), is a sudden onset of spinning type vertigo when you move your head. A senior might notice it turning over in bed or looking up to get something off a shelf. BPPV is caused by an abnormality in the inner ear. Although these bouts of vertigo are brief, they are severe and disturbing. The good news is that BPPV can be treated with medications and with special types of exercises.
  • Meniere’s Disease. Symptoms of Meniere’s Disease, which is caused by a fluid imbalance in the inner ear, include bouts of vertigo combined with hearing loss and ringing in a single ear. The National Institutes of Health estimates that over half a million Americans suffer from Meniere’s disease. It can be treated with diet and medications.
  • Vestibular neuritis. A more serious source of dizziness, vestibular neuritis is an inner ear disorder that may cause a person to experience symptoms such as sudden, severe vertigo, balance problems, nausea, and abnormal back-and-forth eye movements called “nystagmus.” Vestibular neuritis goes away on its own over time, although it may last longer in seniors.
  • Central dizziness. This is a type of dizziness that is caused by a disturbance in the central nervous system, usually by an interruption of blood flow to a part of the brain. Dizziness is usually accompanied by ataxia, or loss of muscle coordination, and nausea. It is actually less common in seniors than in those of middle age.
  • Medical dizziness. Side effects from medications, heart problems, and diabetes can all result in medical dizziness. It is often described as feeling lightheaded or disoriented. Medical dizziness can cause a brief loss of consciousness due to a fall in blood pressure. Medication side effects can also cause “orthostatic hypotension,” which can make you feel dizzy when you stand up or get out of bed.

All types of dizziness, and especially vertigo, can contribute to falls in seniors. It is important to know that dizziness, vertigo, and imbalance are not a normal part of aging, and that treatment is available. Older people do not need to live in fear of falling. Please see our tips on promoting home safety and preventing falls.

Warning Signs For Caregivers

Some symptoms that may be seen with dizziness demand immediate attention. If any of the following symptoms accompany dizziness, treat it as a medical emergency:

  • High fever, severe headache or stiff neck
  • Convulsions or vomiting
  • Head trauma
  • Loss of consciousness
  • Sudden weakness or inability to move an arm or leg
  • Chest pain or shortness of breath

- Written By

Chris Iliades

Chris Iliades, MD has many years of experience in clinician medicine, clinical research, and medical writing. After 15 years in private practice as a board-certified ear, nose, and throat specialist, he helped start a clinical research support company and served as its medical director.