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2010 ; 18
(5
): 386-91
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Geriatric vestibulopathy assessment and management
#MMPMID20613528
Furman JM
; Raz Y
; Whitney SL
Curr Opin Otolaryngol Head Neck Surg
2010[Oct]; 18
(5
): 386-91
PMID20613528
show ga
PURPOSE OF REVIEW: This review discusses the demographics of dizziness in the
older person, the evaluation of the older dizzy patient and how the treatment of
dizziness in older patients differs from that in younger individuals. RECENT
FINDINGS: Seven percent of all visits to primary care physicians for patients
older than 65 years of age are for dizziness, and dizziness is the most common
complaint for patients older than 75 years. In a German study, the 12-month
prevalence of vertigo in the general population was 5% with an incidence of 1.4%
in adults overall. For individuals aged 60-69 the 12-month prevalence was found
to be 7.2% and in individuals 70 years of age or older 8.9%. Data from the United
States National Health and Nutrition Examination Surveys indicated that the
prevalence of vestibular dysfunction for individuals in the seventh decade of
life, eighth decade of life, and older was 49.4, 68.7, and 84.8 percent,
respectively. Only subtle age effects are seen on caloric and rotational testing
whereas vestibular evoked myogenic potentials (VEMPs) change somewhat with age.
Particle repositioning for benign paroxysmal positional vertigo combined with
vestibular rehabilitation is more effective than only performing the
repositioning maneuver. Tai Chi appears to be an effective intervention for older
adults at risk for falling. SUMMARY: When caring for an older dizzy patient
always assess medication use, perform a Dix-Hallpike maneuver, obtain orthostatic
vital signs, discuss fall risk precautions, and consider referral for vestibular
rehabilitation.