Benign paroxysmal positional vertigo in the elderly

Gerontology. 2013;59(5):408-12. doi: 10.1159/000351204. Epub 2013 May 15.

Abstract

Background: Benign paroxysmal positional vertigo (BPPV) is the most frequent peripheral vertigo in the elderly. It is a well-characterized entity and generally easy to treat.

Objective: To evaluate the main symptoms, time to consult for the problem, vertigo characteristics, treatment and follow-up in patients over 70 with BPPV.

Methods: This was a retrospective cohort study. Four hundred and four patients were diagnosed to have BPPV (between January 2006 and December 2012); 211 of them were ≥70 years old (mean 77.7 years) and 193 <70 years old (mean 53.82 years).

Results: Patients over 70 with BPPV took longer to consult for the problem (Spearman rho, p = 0.01). The frequency of a clinical presentation consisting of unsteadiness or imbalance without vertigo sensation is higher among elderly patients (χ(2), p = 10(-6)). The effectiveness of the repositioning maneuver is lower than in patients under 70 (χ(2), p = 0.002), and the recurrences are more frequent (χ(2), p = 0.04).

Conclusion: BPPV is a frequent entity in the elderly, and it is necessary to take it into account when older patients complain about imbalance. An appropriate treatment with repositioning maneuvers and prolonged follow-up are required in order to detect recurrences.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Benign Paroxysmal Positional Vertigo
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Recurrence
  • Retrospective Studies
  • Semicircular Canals / physiopathology
  • Treatment Outcome
  • Vertigo / diagnosis*
  • Vertigo / physiopathology
  • Vertigo / therapy