Dizziness is the most common disease in seniors that leads to frequent visits to doctor. The symptoms are often identified as dizziness, lightheaded, fainting, nausea, falling, etc. Most of them describe their condition with a mix of symptoms which makes it difficult to analyze.  

Generally, the symptoms of dizziness can be divided into 2 types:

  1. Acute dizziness – the condition usually develops within less than 1-2 months
  2. Chronic dizziness – the condition usually develops over more than 1-2 months

Dizziness can happen to anybody from the very young to the elderly. The difference is that in older people it takes longer to recover from the condition than in the younger ones, due to physical degeneration and comorbidities. Here, we discuss mainly people with chronic dizziness.  

Chronic dizziness in seniors is associated with many diseases or other physical frailties such as:

  • Greater risk of a fall
  • Restricted ability to perform daily routine
  • Drop in blood pressure after standing up
  • Cerebrovascular disease
  • etc.

If the condition becomes chronic without proper treatment, it can lead to depression in seniors as they will consumed with being “afraid they might fall” and start to be worried about their illnesses. Then, they will be more withdrawn. This will eventually affect their quality of life. To avoid such a situation, we need to understand their physiology – their sensory apparatus that helps the body maintain its postural equilibrium such as eyes, ears, nervous system, muscular system, and strong bones – which now have degenerated over time, resulting in loss of balance and dizziness. 

Causes of Dizziness in Seniors

  1. Ear diseases such as Meniere’s disease, benign paroxysmal positional vertigo (BPPV), benign tumor or acoustic neuroma, inner ear infection or labyrinthitis, side effects of some medications on auditory nervous system. 
  2. Neurological disorders such as transient and permanent ischemic stroke, Parkinson’s disease, some migraine conditions 
  3. Problems around the neck area in seniors such as degenerative disc disease, or narrowing of jugular vein, or having plaque buildup in the neck arteries which may cause dizziness when turning the head too fast as there can be a temporary blockage of blood vessels.   
  4. Orthostatic Hypotension. Today there is no formal research on the basis for diagnosis of this disease for senior.   So, in Thailand, we use the same existing principles as for patients of other age groups.   It is interesting to find some international studies indicating that orthostatic hypotension does not necessarily come with dizziness.  Thus, there may be other causes for dizziness in seniors while standing up.
  5. Postprandial hypotension occurs when blood pressure decreases 20 mmHg while sitting or standing up 1-2 hours after a meal.
  6. Psychiatric disorders such as depression, anxiety, panic, or obsessive-compulsive disorder in the elderly – all of which can cause dizziness.  The most common disorder is depression which can be both the cause and result of dizziness.
  7. Side effects of medications can cause dizziness from different response to the medicines for blood pressure, diuretic, antiseizure, cardio-regulatory, allergies, antibiotics, sleep, and psychiatric disorders, etc.
  8. Eyes Diseases such as cataracts, glaucoma, macular degeneration.
  9. Other diseases such as hypertension, hypothyroidism, anemic, electrolyte imbalance, dyslipidemia, diabetes, cardiovascular disease, etc.


In summary, although causes of dizziness are clearly classified, for seniors, their symptoms can come from a combination different condition. Therefore, it is necessary to consult a doctor and have your medical history examined properly in order to receive an effective treatment.