Vertigo in the elderly

Half the elderly referrals to a vestibular clinic have, as their principal diagnosis, a central vestibular lesion and a quarter have a peripheral lesion. Many patients also have widespread impairment of postural control so that a precise diagnosis is often difficult. Drugs are rarely of help, except for peripheral vestibular lesions and exercises to improve balance and confidence are often found to be the best approach for vertiginous patients.