Kwon Kyung-hyun, Head of Neurology, Seran Hospital

There is a very common symptom that ranks among the top five reasons for outpatient and emergency room visits by older adults: dizziness. According to statistics, 30% of people aged 65 and older experience dizziness, and among those aged 80 and above, more than 40% have recurrent dizziness. In other words, up to four out of ten older adults experience dizziness in daily life.

Although dizziness is common in older adults, many patients regard it as unimportant, attributing it to feeling unwell or lack of sleep. However, in older adults, the secondary risks arising from dizziness can be considerable. In particular, it is linked to falls and fractures, prodromal signs of cardiovascular disease, and adverse drug effects, and may be an important warning signal rather than a trivial symptom.

Kwon Kyung-hyun, Head of Neurology at Seran Hospital, explained, “In older adults, dizziness often does not stem from a single cause; rather, multiple declines in bodily functions act together. Dizziness presents in various ways, such as a spinning sensation, lightheadedness, or loss of balance,” and added, “It is common to feel unsteady when turning the head, to stagger while walking, and to become dizzy when changing posture.”

As aging begins, vestibular function (ear), vision, and proprioception of muscles and joints all decline, reducing the ability to maintain balance. Benign paroxysmal positional vertigo is the most common cause of dizziness in older adults, and vestibular neuritis and Meniere disease are also representative conditions that occur as vestibular function degenerates with aging.

Visual function may also decline due to ophthalmic conditions such as cataract and glaucoma. Cerebrovascular and neurologic diseases and cardiovascular diseases are also cited as causes, and sudden dizziness can be an early symptom of arrhythmia (an irregular heartbeat), stroke, or reduced cardiac function.

Adverse drug effects and worsening of chronic diseases may manifest as dizziness. Medications commonly taken by older adults, such as antihypertensives, sleeping pills, and antidepressants, can provoke dizziness, which may indicate problems such as abnormal blood pressure control or dehydration. The more medications a person takes, the higher the risk of falls, so it is important to have regular medication reviews with a primary physician.

Kwon Kyung-hyun of the Neurology Department at Seran Hospital explained, “When diabetes is poorly controlled, diabetic peripheral neuropathy dulls sensation in the soles of the feet and increases the risk of falls, and smoking accelerates vascular aging and raises cardiovascular risk,” and added, “Older adults have reduced balance and muscle strength, so even mild dizziness can make them fall easily. If it leads to a hip fracture, mortality is very high, so it is best to watch for dizziness symptoms and visit a hospital before it results in a serious accident.”