A Guide to Dizziness in the Elderly

The term “dizziness” covers a variety of feelings and typically refers to a state of affected balance and an altered sense of space, such as a feeling of weakness or a sense that the world is spinning.

It can be triggered by medications, diet, disease, and a host of environmental factors. While it’s normal to feel a little dizzy every now and then, such as when you have been sitting for long periods and suddenly stand, consistent dizzy spells may be indicative of a more serious issue.

Many of the causes of dizziness are more common in the elderly and it’s important to address them as soon as possible.

What to Do if You are Feeling Dizzy

If you are suffering from repeated bouts of dizziness, book an appointment with your doctor. They will ask about your diet, lifestyle, sleep schedule, and when the dizzy spells appear, all with the goal of determining the cause. Tests will be conducted to see if there are any obvious causes, such as issues with your heart, brain, or blood.

If you have a dizzy spell that is accompanied by any of the following symptoms, seek medical help:

  • Chest pain
  • Difficulty breathing
  • Pain or numbness in the arm
  • Passing out
  • A sudden and crippling headache
  • Double vision and other serious visual disturbances
  • Seizures
  • Vomiting
  • Numbness or weakness in the face
  • Rapid heart rate
  • Slurred speech

These symptoms may suggest that there is a serious problem that requires immediate attention, including a stroke or heart attack. We understand how scary that statement is, so it’s worth noting that such symptoms don’t always indicate a major cardiac episode.

For instance, if you’re prone to anxiety, it’s likely that you will have a rapid heart rate and even high blood pressure as soon as your dizziness kicks in and you start to panic.

Causes of Dizziness in the Elderly

Dizziness is a symptom, not a disease/disorder, and there are several causes, including:

Inner Ear Problems

Your inner ear and sensory system help with balance and movement. When this system is affected, you may feel unsteady or that the world is spinning. If there is an infection in this area, it can cause extreme feelings of vertigo. Conditions such as Meniere’s disease, which is caused by a build-up of fluid, also cause problems with balance that often last for several hours at a time.

Migraines cause similar problems, as well as vision disturbances and sensitivity to light and noise. These aren’t always accompanied by a headache and the triggers and symptoms can differ from person to person.

Cardiovascular Problems

A sudden drop in your systolic blood pressure, the top number on a blood pressure reading, can cause dizziness. Standing up too quickly is the most common cause, but it can also strike if you have the bath water too hot and jump up quickly. 

Heart problems, including heart attacks and heart disease, cause dizziness as well.

Anxiety Problems

Anxiety issues are on the rise and it’s a scary and worrying trend, as the symptoms often mimic more serious and life-threatening conditions. A panic attack triggers symptoms such as dizziness, chest pains, breathing problems, and more. These attacks don’t always have an obvious cause and often result from a build-up of stress and anxiety.

Carbon Monoxide Poisoning

The symptoms of carbon monoxide poisoning include chest pains, breathing difficulties, lightheadedness, and vomiting. It often occurs because of faulty appliances, including gas stoves and boilers, and as the symptoms mimic flu, the person may resort to bed rest, unknowingly putting themselves at risk.

You can’t smell carbon monoxide and may be oblivious if there is a leak. Unfortunately, over 400 people die from carbon monoxide poisoning every year in the United States, with more than 50,000 visiting the emergency room.

On the plus side, there is an easy fix. Simply buy a carbon monoxide alarm and it will sound loudly and clearly if there is a leak.


Dehydration becomes more common with age. Symptoms range from lightheadedness and dry mouth to organ damage and seizures. It’s important to stay hydrated and to drink water even when you don’t feel thirsty. 

The “8 glasses of water” recommendation doesn’t tell the whole story. If you subsist on a diet rich in whole fruits and vegetables, you may need less. If you live in a hot climate and exercise a lot, and you’ll need more. 

Fruit juice, tea, coffee, and even soda count toward your daily fluid intake, but avoid consuming too much sugar and caffeine.

Vitamin Deficiencies

Iron, B-12, B-6, and other nutrient deficiencies cause symptoms like dizziness and fatigue. Deficiencies are caused by absorption problems, diseases, and an inadequate diet. 

Iron deficiencies, for example, are more common in menopausal women due to the loss of blood. Vitamin B-12 deficiency is more common in vegans, as this nutrient is commonly found in eggs, milk, meat, and fish.


Sedatives, opioids, blood pressure medications, and antidepressants are all known to cause dizziness. If medications are the cause, it may be easier to pinpoint and address the issue.

Speak to your doctor about changing your meds or altering the dose if you are concerned about side effects.

Low Blood Sugar

If your blood sugar drops, you may experience dizzy spells. It’s more common in diabetics but can also occur in people who go for extended periods of time without eating.

Treatments for Dizziness in the Elderly

The first step to treating dizziness is to diagnose the cause. Blood, hearing, and balance tests may be conducted, and medications will be checked.

Regular dizzy spells are more of an immediate concern in elderly patients than they are in younger ones. Their balance may be affected, and as their bones/muscles are weaker and their skin is thinner, a fall is more likely to cause harm. 

However, as many causes are the result of new medications, dietary changes, and other treatable conditions, dizziness often goes away on its own as the body adapts.