Dizziness is not usually serious, but for older adults, it can increase the risk of falling. Vertigo, inner ear disturbances, and new medications are a few potential causes.

Everyone has felt dizzy at some point, but the definition of dizziness often differs between individuals. In general, people describe dizziness as feeling:

  • lightheaded
  • off-balance
  • faint or weak
  • as if they are spinning, or as if the room is moving (vertigo)

The causes of dizziness vary. An occasional bout of dizziness isn’t usually anything to worry about.

However, in older people, frequent bouts of dizziness can lead to unexpected falls or be a symptom of another health condition.

In addition to determining the cause of your dizziness, discovering ways to reduce your fall risk is a top priority.

Dizziness in older adults can have many possible causes. It could be due to an underlying health condition, a new medication, an inner ear disturbance, or a combination of factors.

Here’s a rundown of the most common causes of dizziness in older adults.

Vertigo

Vertigo is a vestibular, or balance, disorder that causes short periods of dizziness. It’s often described as a feeling of spinning.

The most common type of vertigo is benign paroxysmal positional vertigo (BPPV). A sudden change of your head’s position can trigger it. In older people, going from a lying down position to standing up may trigger BPPV.

Loose calcium-carbonate crystals, called otoconia, within the fluid-filled semicircular canals of the inner ear cause BPPV.

While vertigo and BPPV are not considered serious conditions, they can increase the risk of falls for older adults.

Meniere disease

While less common than BPPV, Meniere disease is another balance disorder that affects the inner ear. It usually only affects one ear. It often causes periods of dizziness.

People with Meniere disease may also experience:

  • hearing loss in the affected ear
  • loss of balance
  • tinnitus (ringing in the ears)

Meniere disease is a chronic condition. The condition often goes into remission after a few years with medications and lifestyle strategies.

Cardiovascular issues

Any cardiovascular issue that reduces your heart’s ability to pump blood throughout your body can cause dizziness. Sudden drops in blood pressure that occur with position changes, called orthostatic hypotension, can also cause brief bouts of dizziness.

Additionally, conditions that result in poor blood circulation and inadequate blood flow to the brain can leave you dizzy. These may include:

Neurological conditions

Certain chronic neurological conditions, such as multiple sclerosis and Parkinson’s disease, can lead to progressive loss of balance.

Medications

Certain medications may lead to dizziness as a side effect. The most common medications that may cause dizziness in older people include:

Often, drug-induced dizziness may resolve once your body gets used to the medication. If the dizziness doesn’t resolve or worsens, discuss options with your doctor.

Other causes of dizziness

Some additional causes of dizziness in older people can include:

  • Low iron (anemia): Low iron in your blood reduces the amount of oxygen in your body. Along with dizziness, people experience weakness, fatigue, and pale skin.
  • Hypoglycemia (low blood sugar): Symptoms of low blood sugar include dizziness, confusion, sweating, and anxiety. Low blood sugar is most common in people with diabetes.
  • Carbon monoxide poisoning: Exposure to carbon monoxide is usually also associated with nausea, weakness, chest pain, and confusion.
  • Dehydration and overheating: A loss of fluids can cause dizziness, especially if you’re taking certain medications.

Treatment for dizziness depends on the underlying cause.

If a new medication is causing your dizziness, many times your body adjusts and the dizziness resolves in a few weeks.

If you’re taking multiple medications for different issues, make sure your doctor knows all your current medications before they prescribe a new one. This can help avoid the possibility of worsening your dizziness.

Standard treatments for dizziness can include:

  • Balance exercises (vestibular rehabilitation): Balance exercises are a physical therapy used when your dizziness is due to inner ear conditions.
  • Medications: Your doctor may prescribe certain medications for dizziness. Which drug they prescribe depends on the cause of your dizziness but may include:
    • water pills
    • antihistamines
    • anticholinergics
    • anti-anxiety medications (benzodiazepines)
    • preventive migraine medications
  • Canalith repositioning: These are head position movements done with a professional that can help relieve BPPV. Improvements are usually seen within two sessions.
  • Injections: Antibiotic injections may be used in the inner ear to disable the balance function. The unaffected ear should then take over the balance function.
    • Note: Injections are only used to treat severe cases of Meniere disease when other treatments aren’t effective.

The most serious consequence of dizziness is the increased risk of falling.

For older adults, this is especially important because they have a higher risk of injuries, such as head trauma, bone fractures, and soft tissue damage. These injuries could lead to long-term disability.

To prevent falls from dizziness, consider the following strategies:

  • Stay physically active for improved strength and balance.
  • Install handrails in your home.
  • Stand up slowly, and always keep a chair nearby.
  • Use an assistive device, such as a cane or walker.
  • Fasten all carpets and rugs to the floor.
  • Ensure you have good lighting at home.
  • Prepare food while seated.
  • Use a “reach stick” to get items on high shelves.
  • Wear non-skid, rubber-soled shoes.
  • Talk with your doctor if a new medication is making you dizzy.

Any time you get dizzy, you are at an increased risk of falling. By noticing when you may experience dizziness, you can take steps to stay safe in the event of a fall.

Many people feel dizzy, unsteady, or off-balance at times, but dizziness in older people may have several causes that need treatment. Vertigo, inner ear disturbances, new medications, or certain neurological conditions can all cause dizziness.

For older people with frequent dizzy spells, falling is a major concern. It’s important to know what might be causing your dizziness to minimize the risk of serious injury from a fall.

While dizziness itself is not usually serious, taking steps to treat it can help prevent a disabling injury from falls.