Vestibular disorders in old age vertigo
Abstract
Objectives: Good health is not only a privilege of young generation but also of elderly people. Nowadays 13% of the population has reached the age of 65, and one third of them have vertiginous attack at least once in their life. 45-70% of the elderly has one or more drop attacks yearly.
Methods: In the Semmelweis University Otoneurological Department, 17% of the patients are more than 65 years old. Detailed audiological and otoneurological examination was performed.
Results: The origin of vertigo was extravestibular, like depression and anxiety disorder in 28% of the patients and vascular in 42%. Only in 30% specific balance system disease was observed.
Together with presbyacousia a slight loss in balancing appears. Gradually, elderly patients start noticing some unsteadiness or fear to keep moving. The presbyvertigo and presbyataxia are caused by the slow degeneration of vestibular end organs and brainstem pathways. The deterioration of sensorial organs and the central signal processing problems mean that our brain is getting old due to age.
Conclusions: The reasons of the old age vertigo are the decreased physical activity, concomitant diseases, increasing occurrence of vascular risk factors, degeneration of the cervical mechanoreceptors, and anxiety disorders with depression. The possibilities of the treatment: vasoactive and neuroprotective drug administration, adequate treatment of the concomitant diseases. The early mobilisation of patients with vertigo is very important so as to avoid sedative drug administration.
By means of improving diagnostic procedures, successful prevention and therapy the disability can be avoided.
