Vertigo pp 385-392 | Cite as

Vertigo, dizziness, and falls in the elderly

  • Thomas Brandt

Abstract

Basically most of the vestibular or non-vestibular disorders that cause dizziness or vertigo also occur in the elderly, some less frequently (e.g. basilar migraine or motion sickness), others more frequently (e.g. benign paroxysmal positioning vertigo or vascular vertigo). One might question whether this topic still warrants a separate chapter.

Keywords

Drop Attack Postural Imbalance Vestibular Sensory Epithelium High Level Gait Cautious Gait 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Anniko M (1983) The aging vestibular hair cell. Am J Otolaryngol 4: 151–160PubMedCrossRefGoogle Scholar
  2. Atchison PR, Thompson PD, Frackowiak RSJ, Marsden CD (1993) The syndrome of gait ignition failure: a report of six cases. Movem Disord 8: 285–292CrossRefGoogle Scholar
  3. Baker SP, Harvey AH (1985) Fall injuries in the elderly. Clin Geriatr Med 1: 501–508PubMedGoogle Scholar
  4. Baloh RW (1992) Dizziness in older people. J Am Geriatr Soc 40: 713–721PubMedGoogle Scholar
  5. Baloh RW, Jacobson KM, Socotch TM (1993) The effect of aging on visual-vestibuloocular responses. Exp Brain Res 95: 509–516PubMedCrossRefGoogle Scholar
  6. Belal A, Glorig A (1986) Dysequilibrium of aging (presbyastasis). J Laryngol Otol 100: 1037–1041PubMedCrossRefGoogle Scholar
  7. Bergstrom B (1973) Morphology of the vestibular nerve II. The number of myelinated vestibular nerve fibres in man at various ages. Acta Otolaryngol (Stockh) 76: 173–179CrossRefGoogle Scholar
  8. Bloom J, Katasarkas A (1989) Paroxysmal positional vertigo in the elderly. J Otolaryngol 18: 96–98PubMedGoogle Scholar
  9. Brandt Th, Krafczyk S, Malsbenden I (1981) Postural imbalance with head extension: improvement by training as a model for ataxia therapy. Ann NY Acad Sci 374: 646–649CrossRefGoogle Scholar
  10. Camicioli R, Panzer VP, Kaye J (1997) Balance in the healthy elderly. Posturography and clinical assessment. Arch Neurol 54: 976–981Google Scholar
  11. Campbell AJ, Borrie MJ, Spears GF (1989) Risk factors for falls in a community-based prospective study of people 70 years and older. J Gerontol 44: M112 - M117PubMedGoogle Scholar
  12. Campbell AJ, Reinken J, Allan BC, Martinez GS (1981) Falls in old age: a study of frequency and related clinical factors. Age Ageing 10: 264–270PubMedCrossRefGoogle Scholar
  13. Campbell AJ, Diep C, Reinken J, McCosh L (1985) Factors predicting mortality in a total population sample of elderly. J Epidemiol Commun Health 39: 337–342CrossRefGoogle Scholar
  14. Colledge NR, Wilson JA, Macintyre CCA, MacLennan WJ (1994a) The prevalence and characteristics of dizziness in an elderly community. Age Ageing 23: 117–120PubMedCrossRefGoogle Scholar
  15. Colledge NR, Cantley P, Peaston I, Brash H, Lewis S, Wilson JA (1994b) Ageing and balance: the measurement of spontaneous sway by posturography. Gerontology 40: 273–278PubMedCrossRefGoogle Scholar
  16. Colledge NR, Barr-Hamilton RM, Lewis SJ, Sellar RJ, Wilson JA (1996) Evaluation of investigations to diagnose the cause of dizziness in elderly people. Br Med J 313: 788–792CrossRefGoogle Scholar
  17. Collins JJ, De Luca CJ, Burrows A, Lipsitz LA (1995) Age-related changes in open-loop and closed-loop postural control mechanisms. Exp Brain Res 104: 480–492PubMedCrossRefGoogle Scholar
  18. Creasey H, Rapaport SI (1985) The aging human brain. Ann Neurol 17: 2–10PubMedCrossRefGoogle Scholar
  19. Cummings SR, Kelsey JL, Nevitt MC, O’Dowd KJ (1985) Epidemiology of osteoporosis and osteoporotic fractures. Epidemiol Rev 7: 178–208PubMedGoogle Scholar
  20. Daffner KR, Scinto LM, Weintraub S, Guinessey J, Mesulam MM (1994) The impact of ageing on curiosity as measured by exploratory eye movements. Arch Neurol 51: 368–376PubMedCrossRefGoogle Scholar
  21. Davis LE (1994) Dizziness in elderly men. J Am Geriatr Soc 42: 1184–1188PubMedGoogle Scholar
  22. Dietz V, Berger W, Horstmann GA (1988) Posture in Parkinson’s disease: impairment of reflexes and programming. Ann Neurol 24: 660–669PubMedCrossRefGoogle Scholar
  23. Downton JH (1994) Editorial: falls in the elderly—epidemiology, classification and causes. J Audiol Med 3: 3–13Google Scholar
  24. Downton JH (1996) Falls in the elderly: a clinical view. In: Bronstein AM, Brandt Th, Woollacott M (eds) Clinical disorders of balance, posture and gait. Edward Arnold, London, pp 326–341Google Scholar
  25. Downton JH, Andrews K (1991) Prevalence, characteristics and factors associated with falls among the elderly living at home. Aging 3: 219–228PubMedGoogle Scholar
  26. Elble RJ, Hughes L, Higgins C (1992) The syndrome of senile gait. J Neurol 239: 71–75PubMedCrossRefGoogle Scholar
  27. Engstrom H, Bergstrom B, Rosenhall U (1974) Vestibular sensory epithelial. Arch Otolaryngol 100: 411–418PubMedCrossRefGoogle Scholar
  28. Fife TD, Baloh RW (1993) Disequilibrium of unknown cause in older people. Ann Neurol 34: 694–702PubMedCrossRefGoogle Scholar
  29. Gabell A, Simons MA, Nayak USL (1985) Falls in the healthy elderly: predisposing causes. Ergonomics 28: 965–975PubMedCrossRefGoogle Scholar
  30. Gleeson M, Felix H (1987) A comparative study of the effect of age on the human cochlear and vestibular neuroepithelia. Acta Otolaryngol (Stockh) Suppl 436: 103–109CrossRefGoogle Scholar
  31. Glick R, Bondareff W (1979) Loss of synapses in the cerebellar cortex of the senescent rat. J Gerontol 34: 818–822PubMedCrossRefGoogle Scholar
  32. Gryfe JS, Amies A, Ashley MJ (1977) A longitudinal study of falls in an elderly population: I. incidence and morbidity. Age Ageing 6: 201–210Google Scholar
  33. Horak FB, Shupert CL, Mirka A (1989) Components of postural dyscontrol in elderly: a review. Neurobiol Aging 10: 727–738PubMedCrossRefGoogle Scholar
  34. Hirvonen TP, Aalto H, Pyykkö I, Juhola M, Jäntti PO (1997) Changes in vestibulo-ocular reflex of elderly people. Acta Otolaryngol (Stockh) Suppl 529: 108–110CrossRefGoogle Scholar
  35. Hytönen M, Pyykkö I, Aalto H, Starck J (1993) Postural control and age. Acta Otolaryngol (Stockh) 113: 119–122CrossRefGoogle Scholar
  36. Jäntti PO, Pyykkö VI, Hervonen AU (1993) Falls among elderly nursing home residents. Public Health 107: 89–96PubMedCrossRefGoogle Scholar
  37. Johnsson L (1971) Degenerative changes and anomalies of the vestibular system in man. Laryngoscope 81: 1682–1694PubMedCrossRefGoogle Scholar
  38. Kapoor WN (1994) Syncope in older persons. J Am Geriatr Soc 42: 426–436PubMedGoogle Scholar
  39. Katasarkas A (1994) Dizziness in aging: a retrospective study of 1194 cases. Otolaryngol Head Neck Surg 110: 296–301CrossRefGoogle Scholar
  40. Kristinsdottir EK, Jarnlo GB, Magnusson M (1997) Aberrations in postural control, vibration sensation and some vestibular findings in healthy 64–92 year-old subjects. Scand J Rehab Med 29: 257–265Google Scholar
  41. Lajoie Y, Teasdale N, Bard C, Fleury M (1996) Upright standing and gait: are there changes in attentional requirements related to normal aging? Exp Aging Res 22: 185–198PubMedCrossRefGoogle Scholar
  42. Lee MS, Marsden CD (1996) Drop attacks. In: Bronstein AM, Brandt Th, Woollacott M (eds) Clinical disorders of balance, posture and gait. Edward Arnold, London, pp 177–187Google Scholar
  43. Litvan I, Agid Y, Jankovic J, Goetz C, Brandel JP, Lai EC, Wenning G, D’Olhaberriague U, Verny M, Chaudhuri KR, McKee A, Jellinger K, Bartko JJ, Magone CA, Pearce RK (1996) Accuracy of clinical criteria for the diagnosis of progressive supranuclear palsy ( Steele-Richardson-Olszewski syndrome ). Neurology 46: 922–930Google Scholar
  44. Marsden CD, Thompson PD (1996) Frontal gait disorders. In: Bronstein AM, Brandt Th, Woollacott M (eds) Clinical disorders of balance, posture and gait. Edward Arnold, London, pp 188–193Google Scholar
  45. Meissner I, Wiebers DO, Swanson JW, O’Fallon WM (1986) The natural history of drop attacks. Neurology 36: 1029–1034PubMedCrossRefGoogle Scholar
  46. Morrow MJ, Sharpe JA (1993) Smooth pursuit initiation in young and elderly subjects. Vision Res 33: 203–210PubMedCrossRefGoogle Scholar
  47. Nevitt MC, Cummings SR, Kidd S, Black D (1989) Risk factors for recurrent non-syncopal falls. A prospective study. JAMA 261: 2663–2668Google Scholar
  48. Newman G, Dovenmuehle RH, Busse EW (1960) Alterations in neurological status with age. J Am Geriatr Soc 8: 915–917Google Scholar
  49. Nigg BM, Fisher V, Ronsky IL (1994) Gait characteristics as a function of age and gender. Gait Posture 2: 213–220CrossRefGoogle Scholar
  50. Norré ME, Forrez G, Beckers A (1987) Vestibular dysfunction causing instability in aged patients. Acta Otolaryngol (Stockh) 104: 50–55CrossRefGoogle Scholar
  51. Nutt JG, Marsden CD, Thompson PD (1993) Human walking and higher-level gait disorders, particularly in the elderly. Neurology 43: 268–279PubMedCrossRefGoogle Scholar
  52. Paige GD (1991) The ageing vestibulo-ocular reflex (VOR) and adaptive plasticity. Acta Otolaryngol (Stockh) Suppl 481: 297–300CrossRefGoogle Scholar
  53. Paige GD (1994) Senescence of human visual-vestibular interactions: smooth pursuit, optokinetic, and vestibular control of eye movements with aging. Exp Brain Res 98: 355–372PubMedCrossRefGoogle Scholar
  54. Park JC, Hubel SB, Woods AD (1987) Morphometric analysis and fine structure of the vestibular epithelium of aged C57BL/6Nia mice. Hear Res 28: 87–96PubMedCrossRefGoogle Scholar
  55. Peterka RJ, Black FO (1990a) Age-related changes in human posture control: sensory organization tests. J Vestib Res 1: 73–85PubMedGoogle Scholar
  56. Peterka RJ, Black FO (1990b) Age-related changes in human posture control: motor coordination tests. J Vestib Res 1: 87–96PubMedGoogle Scholar
  57. Peterka RJ, Black FO, Schoenhoff MB (1990a) Age-related changes in human vestibulo-ocular and optokinetic reflexes: pseudorandom rotation tests. J Vestib Res 1: 61–71PubMedGoogle Scholar
  58. Peterka RJ, Black FO, Schoenhoff MB (1990b) Age-related changes in human vestibulo-ocular reflexes: sinusoidal rotation and caloric tests. J Vestib Res 1: 49–59PubMedGoogle Scholar
  59. Prince F, Corriveau H, Hébert R, Winter DA (1997) Gait in the elderly. Gait Posture 5: 128–135CrossRefGoogle Scholar
  60. Prudham D, Evans JG (1981) Factors associated with falls in the elderly: a community study. Age Ageing 10: 141–146PubMedCrossRefGoogle Scholar
  61. Pyykkö I, Jäntti PO, Aalto H (1990) Postural control in elderly subjects. Age Ageing 19: 215–221PubMedCrossRefGoogle Scholar
  62. Ray WA, Federspiel CF, Baugh DK, Dodds S (1987) Interstate variation in elderly Medicaid nursing home populations. Med Care 25: 738–752PubMedCrossRefGoogle Scholar
  63. Ray WA, Griffin MR (1990) Prescribed medications and the risk of falling. Top Geriatr Rehab 5: 12–20Google Scholar
  64. Ray WA, Griffin MR, Baugh DK (1990) Mortality following hip fracture before and after implementation of the prospective payment system. Arch Intern Med 150: 2109–2114PubMedCrossRefGoogle Scholar
  65. Richter E (1980) Quantitative study of human Scarpa’s ganglion and vestibular sensory epithelia. Acta Otolaryngol (Stockh) 90: 199–208CrossRefGoogle Scholar
  66. Rosenhall U (1973) Degenerative patterns in the aging human vestibular neuroepithelia. Acta Otolaryngol (Stockh) 76: 208–228CrossRefGoogle Scholar
  67. Seidler RD, Martin PE (1997) The effects of short term balance training on the postural control of older adults. Gait Posture 6: 224–236CrossRefGoogle Scholar
  68. Sheldon JH (1960) On the natural history of falls in old age. Br Med J II: 1685–1690Google Scholar
  69. Sloane PD, Baloh RW, Honrubia V (1989a) The vestibular system in the elderly: clinical implications. Am J Otolaryngol 10: 422–429PubMedCrossRefGoogle Scholar
  70. Sloane P, Blazer D, George LK (1989b) Dizziness in a community elderly population. J Am Geriatr Soc 37: 101–108PubMedGoogle Scholar
  71. Sudarsky L (1990) Geriatrics: gait disorders in the elderly. N Engl J Med 322: 1441–1446PubMedCrossRefGoogle Scholar
  72. Thapa PB, Ray WA(1996) Medications and falls and fall-related injuries in the elderly. In: Bronstein AM, Brandt Th, Woollacott M (eds) Clinical disorders of balance, posture and gait. Edward Arnold, London, pp 301–325Google Scholar
  73. Tinetti ME (1987) Factors associated with serious injury during falls by ambulatory nursing home residents. J Am Geriatr Soc 35: 644–648PubMedGoogle Scholar
  74. Tinetti ME, Speechley M, Ginter SF (1988) Risk factors for falls among elderly persons living in the community. N Engl J Med 319: 1701–1707PubMedCrossRefGoogle Scholar
  75. Ura M, Pfaltz CR, Allum JHJ (1991) The effect of age on the visuoand vestibulo-ocular reflexes of elderly patients with vertigo. Acta Otolaryngol (Stockh) Suppl 481: 399–402CrossRefGoogle Scholar
  76. Vernadakis A (1985) The aging brain. Clin Geriatr Med 1:61–94 Wild D, Nayak USL, Isaacs B (1980) Characteristics of old people who fell at home. J Clin Exp Gerontol 2: 271–278Google Scholar
  77. Wolfson L, Whipple R, Derby CA, Amerman P, Murphy T, Tobin JN, Nashner L (1992) A dynamic posturography study of balance in healthy elderly. Neurology 42: 2069–2075PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2003

Authors and Affiliations

  • Thomas Brandt
    • 1
  1. 1.Neurologische Klinik, Klinikum GroßhadernLudwig-Maximillians-UniversitätMunichGermany

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