Clinical and etiology of dizziness in patients over 65 years

Clinical and Etiology of Dizziness in Patients Over 65 Years Objective: Dizziness is a term used to define disorientation feeling in space. Patients usually describe themselves as if they are flooting in space. It is a very common condition with a prevelance ranging 11-32.5 %. Its prevelance can increase up to 60 to 70 % in the elderly. This heading includes topics due to different mechanism such as vertigo, dysequlibrium, presyncope and nonspecific dizziness feeling. The objective of this study is to determine the clinical features of patients over 65 presenting with dizziness and to compare their postural stability with the control groups. Methods: The study was performed between January 2014 and August 2016 in patients over 65 years presenting Neurology Department Cukurova University. Hundred patients (48 female, 52 male) with complaints of dizziness and 25 control patients with complaints other than dizziness were included in the study. The control group was used only for posturographic analysis. Difficulties with mobility (severe polyneuropathy, severe cognitive deficit) were considered as the exclusion criteria. The medical history, neurological and neurootological examinations, laboratory values and further examination results were recorded. Balance functions were measured by using the static posturography device. Results: The mean age was 72,6 (minimum:65, maximum:91) for the patients and 68 (minimum:65, maximum:75) for the control group.The most common complaints of patients were determined as fear of falling/being likely to fall (83 %), unsteadiness (76 %), environmental illusion (43 %), dullness (43 %) and inability to stand up (21 %). Standing up was identified as the most common triggering factor (91 %). Patients were categorized in four groups; there were fifty three patients (51 %) in vertigo group, 21 (20.2 %) in presyncope group, 27 (26 %) in dysequlibrium group and 3 (2.8 %) patients in nonspecific dizziness group. In four patients, multiple causes were idendified. Female gender (p=0.001) in vertigo group and male (p=0.003 and p=0.041) gender in presyncope and dysequlibrium group were statistically significant. In vertigo group, 25 (% 27) patients were diagnosed with BPPV. Fifteen (14 %) patients were diagnosed as acute cerebrovascular events and in one patient, vestibular schwannnoma was found. Fifty one (51 %) of the patients in this study were using drugs for dizziness. The most commonly used drugs were piracetam (60 %) and betahistine dihydrochloride (55 %). Conclusion: Dizziness with the adverse effects on the quality of life especially in the geriatric population, is one of the most frequent causes of hospital admissions. And therefore true diagnosis and treatment improve the quality of life. Dizziness being an initial symptom af many central nervous system diseases provides an early diagnosis. Key Words: Dizziness, geriatric population, vertigo, presyncope, dysequlibrium, static posturography.