Benign paroxysmal positional vertigo in the older adults

Abstract

Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of vertigo. The prevalence of the disease increases with age. Course of the disease, clinical manifestations, and treatment approaches at older ages have their own characteristics. Frequent predominance of persistent instability over classic episodes of positional vertigo as well as tendency to chronicity are among the main clinical features of BPPV at advanced age. BPPV in the older adults has a higher frequency of relapses, which is explained by the continuing degenerative processes in the otolith membrane and concomitant diseases that limit physical activity of older patients. The BPPV treatment in the older can be difficult due to the technical problems during canalith repositioning procedures, concomitant diseases and insufficient mobility of patients. Nevertheless, in most cases, the treatment of BPPV in the older adults remains highly effective, which makes early-stage disease detection of great value, even with atypical clinical manifestations. Therefore, it is especially important to perform positional tests in any cases with complaints of dizziness and instability.