Vestibular disorders make older people dizzy and prone to falls. Most are benign, but sudden dizziness can sometimes signal a stroke and needs prompt care.
The vestibular system sits in the inner ear and works with the brain, eyes and musculoskeletal system to tell the body what position the head is in, which keeps us balanced. Vestibular disorders can occur at any age but are more common in older people, and the biggest concern for families is the risk of falls.
Peripheral and central vestibular disorders
Depending on where the damage is, the condition falls into two groups with different causes and severity:
- Peripheral: a problem in the inner ear or the vestibular nerve. The typical feeling is that everything is spinning, especially when turning or changing the position of the head, possibly with nausea, vomiting, ringing in the ears or hearing loss. In a severe attack, the person finds it hard to stand or walk and has to lie still, because the slightest movement makes the dizziness worse.
- Central: the damage lies in the areas of the brain that control balance, which can happen with reduced blood flow to the brain, stroke, neurodegeneration or other brain damage. In older people, this group needs special attention because it may be related to cerebrovascular disease.
Common symptoms
- Dizziness, lightheadedness, or feeling that you or the objects around you are spinning.
- Feeling unsteady on your feet, swaying easily and being prone to falls.
- Nausea and vomiting, especially during a severe dizzy spell.
- Ringing in the ears and hearing loss, more common in the peripheral group.
- Headache, tiredness, difficulty concentrating, feeling weak and finding it hard to manage everyday tasks.
In a mild attack the person can still walk but is unsteady; a severe attack can leave them unable to sit up, vomiting a lot, and at risk of dehydration and electrolyte imbalance. However, dizziness in old age is not always caused by the vestibular system, so the right cause must be found before treatment.
Why it should not be taken lightly
The biggest risk is falling. In old age, bones are often already thin and balance is poorer, so a single sudden dizzy spell can lead to a fall, a fracture or a head injury. In addition, symptoms that resemble a vestibular disorder sometimes come from other conditions:
- Central nervous system disease: stroke, especially in the brainstem or cerebellum, transient ischemic attack (mini-stroke), tumors or neurodegenerative disease. A stroke does not always cause obvious weakness or paralysis; sometimes it shows up only as dizziness, double vision or unsteady walking.
- Heart and blood vessel disease: heart rhythm disorders, heart failure, low blood pressure or vascular disease that reduces the blood supply to the brain, causing lightheadedness. Older people taking many medicines for underlying conditions may also have their blood pressure drop too far, feeling dizzy right after standing up.
- Whole-body conditions: low blood sugar, dehydration, electrolyte imbalance, anemia, fever, infection and certain endocrine disorders.
So when an older person is dizzy, the doctor needs to look at the whole picture rather than rushing to label it a "vestibular" problem.
Signs that need emergency care right away
Sudden dizziness or loss of balance with any of the following signs means the person needs to be taken to a medical facility immediately, as it may be a stroke:
- A drooping mouth, difficulty speaking or swallowing.
- Weakness or numbness on one side of the body.
- Confusion or a severe headache.
- Double vision or being unable to walk unaided.
You should also see a doctor early if the dizziness lasts a long time or keeps coming back, or if the person vomits continuously, cannot stand or walk, shows signs of dehydration or has recently lost some hearing.
Preventing falls and complications
- Sit up and stand up slowly, especially after lying or sitting for a long time.
- Keep the house tidy and well lit, clear obstacles from walkways, and install grab bars in the bathroom and slippery areas.
- Drink enough water, eat regular meals, keep regular sleep hours and stay active within your limits.
- People with high blood pressure, heart disease, diabetes or other chronic conditions should take their medicines as instructed and have regular follow-up visits.
- Do not buy medicine on your own for dizziness; get examined to find the right cause.
Trusted clinic for dizziness and vestibular disorders in Ho Chi Minh City
With nearly 20 years of experience and a team of highly qualified doctors, Ky Hoa Medical Center is a familiar choice for many families in Ho Chi Minh City when they need care for dizziness and vestibular disorders. Here, our Internal Medicine and ENT specialists take time to listen, examine carefully and explain clearly so that you fully understand your condition, then agree together on a treatment and follow-up plan.
The center operates under Operating License No. 00449/HCM-GPHĐ, with a list of medical techniques approved by the Ho Chi Minh City Department of Health (Decision 471/QĐ-SYT), and is a primary care facility contracted with Ho Chi Minh City Social Security, accepting health insurance (BHYT) visits on Saturdays as well. The practising certificates of our 24 doctors are published on our Doctors page.
When your grandparents often feel dizzy or unsteady on their feet, you can bring them to Ky Hoa Medical Center to see a doctor in Internal Medicine or ENT (Ear, Nose & Throat), who will look for the cause and suggest a suitable way to manage it. Simply walk in during opening hours and take a queue number.
Ky Hoa Medical Center
Address: 266A - 268 3 Thang 2 Street, Hoa Hung Ward, Ho Chi Minh City
Opening hours: Monday to Saturday, 6:30 - 11:30 and 13:00 - 17:00 (closed on Sunday)
Hotline: 028.3868.1097
Source: Suc Khoe & Doi Song (Health & Life) newspaper