Characterization of presbyequilibrium among institutionalized elderly persons.

OBJECTIVE: The aim was to characterize dizziness, vertigo, poor maintenance of posture, and sudden instabilities (called presbyequilibrium) among institutionalized elderly to model and identify possible treatable causes.

METHODS: A questionnaire based study focusing on symptoms among 72 elderly persons from a single residential facility and followed them for 3 years.

RESULTS: Dizziness, vertigo, poor maintenance of posture, and black-outs were reported by 68% of the 72 elderly and make them at risk for falls, and reduced quality of life. The most common complaint was postural instability, with a tendency to fall. "Spinning" vertigo and "floating" sensation had a strong inter-correlation and correlated with habitual falls. The various dizziness symptoms often occurred in combinations. Attacks of self-experienced syncope never occurred alone but always in combination with "spinning vertigo" or "tendency to fall". In factorial analysis, presbyequilibrium could be divided into six categories. Two of these categories correlated with falls.

CONCLUSIONS: Among elderly, presbyequilibrium is commonly characterized by a combination of phenomena involving perceptual, orientation, postural, and autonomic manifestations. It is often difficult to obtain an accurate history from the elderly and the presence of vestibular symptoms is frequently overlooked. Taking a careful history and utilizing the classification of symptoms that emerged from the factorial analysis may give a deeper understanding of the etiology of presbyequilibrium, thereby facilitating appropriate rehabilitation.