Simple question can lead to remedy for older adults' dizziness and impaired balance

Benign paroxysmal positional vertigo (BPPV) is common, and often undiagnosed, among senior citizens. Many suffer in silence from dizziness and impaired balance, which have a major impact on their quality of life. Although these symptoms are not life-threatening, those affected are at an elevated risk of feeling unsteady and accidentally falling when they walk.

The purpose of a new thesis presented at Sahlgrenska Academy has been to boost knowledge of older people's dizziness and unsteady gait, focusing on BPPV. The author, Ellen Lindell, is a specialist ear, nose and throat (ENT) doctor at Södra Älvsborg Hospital in Borås, where some of the research was carried out.

One of the studies described in the thesis comprised 149 patients -- 96 women and 53 men -- referred for ENT treatment because of dizziness. In conjunction with being examined, each patient filled in a questionnaire composed of 15 questions. The question most clearly connected with the diagnosis of BPPV was the one about whether the patient felt dizzy on turning over in bed.

"Onset of vertigo when a person lies down or turns over in bed is a quick identifier of BPPV, the most common cause of dizziness, which is potentially curable. Treating it enhances patients' wellbeing and can reduce many older people's suffering and cut costs to society," Lindell says.

BPPV, the most frequent cause of vertigo arising from the balance organs of the inner ear. It is due to otoliths (crystals) from the inner ear loosening and being displaced. The symptoms are dizziness resulting mainly from a change of position. Many people with BPPV also experience unsteadiness when they stand and walk.

The remedy for BPPV is maneuver treatments, often performed by a physical therapist, with the aim of restoring the otoliths to their proper place. The technique involves turning and spinning the patient's whole body, and it varies according to which semicircular canal, on which side of the body, is affected.

Three of ten people aged 70 and over are estimated as suffering from dizziness and impaired balance. According to the thesis, which is also based on data from the extensive Gothenburg H70 population-based study of aging and health, vertigo at age 75 is more common in women than men, but by age 79 this gender difference has disappeared.

Among the 79-year-olds examined, more than half had dizziness and four of ten had suffered accidental falls in the past year. People with dizziness take more medications, are more tired, walk more slowly, are more afraid of falling and have worse self-rated health than people without it.

"The results in my thesis show that for those who are affected by dizziness, it's associated with experiencing inferior health-related quality of life, and their subjective health self-assessments are less favorable than people without dizziness," Lindell says.

Title: Dizziness and Benign Paroxysmal Positional Vertigo among older adults -- health-related quality of life and associated factors; http://hdl.handle.net/2077/62213