Present Status of Dizziness in the Elderly People in a Super-aging Society and Its Problem

Dizziness and imbalance are the most common complaints in older people, and are a growing public health concern. Although the causes of dizziness in older people are multifactorial, peripheral vestibular dysfunction is one of the most frequent causes. Every factor associated with the maintenance of postural stability deteriorates with aging. Age-related deterioration of peripheral vestibular function has been demonstrated through quantitative measurements in the vide head impulse test and evaluation of the vestibulo-collic reflex by testing of vestibular evoked myogenic potentials. Age-related decline of vestibular function has been shown to be correlated with the age-related decrease in the number of vestibular hair cells and neurons. Other factors associated with postural stability, such as somatosensation, visual acuity, cerebellar function, and muscle strength also decline with age. In examining older patients with dizziness or imbalance, it is important to assess each factor associated with postural stability. To improve postural stability, it is recommended that strategies be devised to improve the impaired functions based on the results of the above assessments.