Management of chronic dizziness in elderly people

Dizziness is a frequent complaint in elderly people, and is a broad term used to explain various abnormal sensations related to the perception of the body's relationship to space. Classically, four subtypes are described: vertigo, pre-syncopal lightheadedness, disequilibrium, and other dizziness. Dizziness is often a chronic complaint in elderly people and may lead to dramatic worsened functional and psychosocial outcomes. Dizziness should be approached as a symptom and as a syndrome. In fact, physicians should exclude potential curable causes of dizziness, considering dizziness as a symptom of specific diseases. As dizziness is often multifactorial, it should also be treated as a geriatric syndrome. Physicians should, thus, identify risk factors of recurrent dizziness. The "Dizziness Handicap Inventory Scale" may assist the clinician to establish the extent of the "dizziness" problem. Specific causes of dizziness should be addressed as well as contributive factors (i.e., medications). Vestibular and balance rehabilitation with an interdisciplinary collaboration should start rapidly to avoid psycho-social complications, such as fear of falling.