What causes dizziness and how to fix it

Dear Savvy Senior,

What can cause dizziness in older adults? I have dizzy spells from time to time, but I’m not sure what causes it or what I should do about it.

Dizzy Donna

Dear Donna,

Whether it’s a moment of lightheadedness or the room-whirling sensation of vertigo, dizziness can be very unsettling. As many as 30% of people older than 60 experience dizziness at some point, about 50% after age 85.

This unpleasant sensation only rarely signifies a serious medical condition. But it can knock you off balance, leading to falls and injuries. That’s why anytime you feel dizzy, you should lower yourself to a safe, seated position. Here’s a brief rundown of what typically causes dizziness and what you can do to fix it.

What causes dizziness?

One of the most common causes of dizziness and vertigo in older adults is benign paroxysmal positional vertigo. This occurs when tiny crystals in the inner ear, which play a role in balance, become dislodged. BPPV is more likely as we get older because wear and tear can cause the crystals to shift out of place.

The resulting dizziness is generally triggered by changes in head position. People with BPPV often complain the room spins when they roll over in bed, get into or out of bed, tip their head back, bend over, or make other quick head movements. These episodes usually last only a minute or two, but they may happen intermittently over a period of time.

A drop in blood pressure also may cause dizziness, even fainting, especially when changing position from sitting or lying down to standing. This so-called postural hypotension is often the result of problems with blood pressure medication.

If this is something that occurs on a regular basis, you need to be evaluated by your doctor. Certain sedatives, antidepressants, cough and cold medicines, and antibiotics can lead to dizziness too.

Dehydration may be another culprit in postural hypotension. Staying hydrated is extremely important for balance, blood pressure and general well-being. Declines in vision and hearing including ear infections and impacted earwax also may affect your balance.

When to call a doctor

Occasional dizziness that lasts only for a few seconds is probably no cause for worry, but you should still let your doctor know. If it persists for several minutes or more or keeps happening, call your doctor right away.

Sudden dizziness or loss of balance, along with facial drooping, trouble speaking, nausea, and vision or hearing disturbances, can signal a stroke. If this happens, call 911.

Treatment for dizziness

If your doctor thinks you have BPPV, they can teach you the Epley maneuver, where you turn your head and body in ways that move ear crystals back into place.

For medication-related dizziness, your doctor can change your medication or dosage to reduce the side effects.

For persistent problems, your doctor can check for infections, balance disorders, and more serious issues such as tumors, congestive heart failure, an irregular heart rhythm and conditions like Parkinson’s disease.

If none are found, your doctor may recommend vestibular rehab, which may help with dizziness, vertigo and balance problems. Anxiety and depression also can cause dizziness in some people. Treating this may ease your lightheadedness.

Send your questions or comments to questions@savvysenior.org or to Savvy Senior, P.O. Box 5443, Norman, OK 73070.