Yale Researchers Pinpoint Possible Causes of Dizziness in the Elderly

A Yale study of elderly people found that 24 percent complained of recurring dizziness and that factors such as anxiety, depression and heart disease might cause dizziness.

“This kind of dizziness is common,” said Mary Tinetti, M.D., professor of medicine and public health at Yale School of Medicine. “While it’s believed that dizziness is a symptom of specific diseases, the condition might often be the result of multiple problems working togetherQa condition we call a geriatric syndrome.”

Published in the March 7 issue of Annals of Internal Medicine, the study suggests that by classifying dizziness as a geriatric syndrome, researchers might get closer to identifying the causes of this condition.

The study’s goal, Tinetti said, was to determine the prevalence of dizziness episodes that last for at least one month. Tinetti’s team set out to identify potential characteristics that predispose to dizziness, as well as situational factors, such as sensations or activities that might be present at the time of dizziness.

“Considering dizziness a geriatric syndrome does not mean that a single disease can’t be primarily responsible for the dizziness in a sub-group of people, but does suggest that, in many, if not most older people, severe problems contribute together to cause dizziness,” said Tinetti. “Our results also suggest that clinicians

should focus not only on diagnosing one or a few diseases, but also on identifying potentially treatable contributing factors to dizziness.”

The one-year study included 1,087 community-living persons who were 72 years of age or older. The risk factors found in this group included a previous myocardial infarction, the use of multiple medications, a drop in blood pressure upon standing, anxiety, depression, poor balance and decreased hearing.

Participants were questioned about episodes of dizziness. Of the 1,087 participants, 29 percent reported dizziness in the two months before the interview. Twenty-four percent reported having dizziness for more than one month. The most frequently mentioned sensation was loss of balance and equilibrium. The most frequently cited activities that trigger dizziness were getting up from a lower position (either lying down or sitting), turning the head or the entire body, and being upset or anxious.

If verified, Tinetti said, this study shows that a multi-dimensional approach to identifying and treating as many of the contributing factors as possible may be effective in eradicating or reducing the symptoms of dizziness in older people.

Tinetti’s team included Christianna S. Williams and Thomas Gill, M.D. of Yale School of Medicine. It was supported by a grant from the National Institute on Aging and by the Pepper Aging Center at Yale.

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Karen N. Peart: karen.peart@yale.edu, 203-432-1326