Assessment of dizziness in the elderly population in a special clinic for the treatment of lack of stability, vertigo and falls

Abstract

Objective: describing the characteristics and identifying the main diseases that cause different types of dizziness in elderly people attending a clinic for the treatment of instability, vertigo and falls.

Material and methods: descriptive, transversal trial including 228 people older than 60 with vertigo, dizziness or falls, referred to an interdisciplinary integral care clinic in a university hospital in Manizales, specialized in geriatrics, between January 2001 and December 2006.

Results: the average age was 72,81 years (DE 7.7), 72,7% were women. Dizziness of unknown origin was the most frequent complaint (35.3%), in half of the patients described as a feeling of "drowsiness" in half of them. Vertigo was the second one (33,8%), and this one followed by instability (19,3%) and pre-syncopal dizziness or syncope (11,5%). 38% of the patients referred more than a symptom, especially with instability associated. Half of the patients referred the symptoms for more than a year. All of them had concomitant symptoms with each type of dizziness, anxiety and diaphoresis. At least two pathologies could be cause of the symptoms and pooling them according to systems, cardiovascular causes were the most frequent ones (24,3%), followed by those affecting the peripheral vestibular system (22%) and those of the central nervous system (15,2%). There was a statistically significant association between vertigo and peripheral vestibular pathology (p< 0,01), another type of vertigo with cardiovascular disease (p< 0,05) and pre-syncopal dizziness with cardiovascular as well as with vestibular diagnosis (p< 0,05).

Conclusion: the variability in symptoms description and the heterogeneity of the diagnosis found is the common feature among elderly with dizziness and suggest that dizziness is multifactorial and that an approach pointing to the diagnosis is not the way to go.