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Benign paroxysmal positional vertigo in the elderly: current insights.

D G Balatsouras1, G Koukoutsis1, A Fassolis1

  • 1Department of ENT, Tzanion General Hospital of Piraeus, Piraeus, Greece, dbalats@hotmail.com.

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Summary

Benign paroxysmal positional vertigo (BPPV) is common in the elderly, causing dizziness. While similar to younger patients, BPPV in older adults recurs more often and requires cautious management to prevent complications.

Keywords:
balancebenign paroxysmal positional vertigodizzinesselderlyvestibular

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Area of Science:

  • Geriatric Medicine
  • Neurology
  • Otolaryngology

Background:

  • Balance disorders, unsteadiness, dizziness, and vertigo are significant health concerns in the elderly population.
  • Benign paroxysmal positional vertigo (BPPV) is the most frequent cause of vertigo, affecting one-third of elderly patients diagnosed with the condition.
  • BPPV is characterized by specific positional nystagmus, diagnosable via positional tests and treatable with specific maneuvers.

Purpose of the Study:

  • To review current understanding of the diagnosis, pathogenesis, and treatment of BPPV specifically in elderly patients.
  • To highlight differences and similarities in BPPV presentation and management between elderly and younger individuals.
  • To address specific challenges and considerations for managing BPPV in older adults.

Main Methods:

  • Literature review focusing on diagnostic criteria, pathogenetic mechanisms, and therapeutic interventions for BPPV.
  • Analysis of studies comparing BPPV in elderly versus younger populations.
  • Examination of specific clinical considerations for the elderly, including history taking, maneuver execution, and fall risk.

Main Results:

  • BPPV pathogenesis, diagnosis, and fundamental treatment principles are consistent across age groups.
  • Elderly patients exhibit a higher prevalence of BPPV, with a greater tendency for recurrence and potentially less effective treatment response.
  • Specific challenges in the elderly include obtaining accurate histories, performing diagnostic/therapeutic maneuvers cautiously to avoid complications, and understanding the link to falls.

Conclusions:

  • BPPV management in the elderly requires careful consideration of age-related factors, including cautious maneuver execution and awareness of recurrence risk.
  • Despite similarities in core aspects, BPPV in older adults necessitates tailored approaches due to increased prevalence and potential complications.
  • Further research may be needed to optimize treatment efficacy and recurrence prevention strategies for BPPV in geriatric populations.