Dizziness in aging: a retrospective study of 1194 cases.

In the Royal Victoria Hospital dizziness clinic, 1194 of 9767 (12.22%) patients were 70 years of age or older on the day of the first visit. There were 750 women and 444 men, with no difference in age distribution (p > 0.9). In 367 (27.04%) cases (percentages given as "cases" refer to the number of diagnoses [N = 1357], not the number of patients [N = 1194]), the symptoms were nonspecific, and the diagnosis was uncertain. In 530 (39.13%) patients, paroxysmal positional vertigo was either confirmed or strongly suspected. In the 241 of 254 (94.88%) confirmed cases, the observed paroxysmal nystagmus was compatible with excitation of the posterior semicircular canal. In 119 (8.77%) patients, the dizziness could not be attributed to neurologic or vestibular disease. Meniere's disease, vestibular neuronitis, vascular episodes, and tumors were next in prevalence. The following conclusions were reached: (1) although no difference was found in age distribution between women and men, dizziness was more prevalent among women, which may be because of the higher survival rate of women; (2) the prevalence of paroxysmal positional vertigo was high, with apparent involvement of the posterior semicircular canal in most cases (it is strongly suspected that paroxysmal positional vertigo is frequently misdiagnosed as vascular disease in advanced age); and (3) multisensory deficits, drugs, or systemic diseases, common in the elderly, may cause dizziness. Syndromes affecting the vestibular function, however, may be more prevalent in advanced age than is generally estimated.