Vertigo and Dizziness in the Elderly

Abstract

Vertigo or dizziness is one of the most common complaints in geriatric clinics. Among 2, 554 patients above the age of 49 who visited the Department of Geriatrics, University of Tokyo Hospital during the period from 1970 to 1973, 497 patients (19.5%) (male 17.1%, female 21.8%) had vertigo or dizziness, and it was the chief complaint in 156 (6.1%). Of these 497 patients, 15.5% had vertigo, 59.5% dizziness, and 6.0% both. In the remainder no details were available.
The most important disorders which caused vertigo or dizziness were arterial hypertension (22.9%), anemia (8.9%), vascular disorders either in the vertebrobasilar system (7.4%) or in the carotid system (7.0%), cervical spondylosis (6.8%) and others. The patient ratio vertigo/vertigo+dizziness was the highest in vascular disorders of the vertebrobasilar system (59.1%), then in the disturbance of the inner ears (53.3%) and cervical spondylosis (38.2%).
Then, clinical data were compared among three patient groups matched in age and sex; the group with vertigo (vertigo group), the group with dizziness (dizziness group), and the control group who had had no episodes of vertigo or dizziness. Of five symptoms common in the elderly (heavy headedness, paresthesia of the limbs, tinnitus, shoulder tightness and forgetfulness), all were more frequently seen in the dizziness group than in the control, while in the vertigo group only the first three symptoms were more frequent (p<0.001-0.01). As to physical and neurological status, blood pressure was higher in the dizziness group than in the control, and hemiplegia or tetraplegia was more commonly observed in the vertigo group than in the control (p<0.01).
Of laboratory data, the concentration of total protein in the serum was generally lower in the dizziness group than in the other two, and the difference between the dizziness group and the control was significant in the seventh and eighth decades of age in females (p<0.05). Hemoglobin concentration and red blood cell counts were also lower in the dizziness group than in the other two. The minimum saggital diameter of the spinal canal measured in the plain roentogenogram of the cervical spine was significantly smaller in the vertigo group than in the control in males (p<0.01).
From these results, the followings might be concluded:
(1) Vertigo seems to be closely related to cerebral arteriosclerosis, especially in the vertebrobasilar system.
(2) Dizziness, on the other hand, is often under the influence of such functional factors as blood pressure, concentration of serum protein, hemoglobin content or red blood cell counts, with less specific significance for the indication of the underlying disorders.