Lightheadedness not same as vertigo
Dear Dr. Roach: Why do older people tend to get lightheaded (not vertigo) and therefore become liable to trip or fall? What causes that, and can anything be done? I’m an 83-year-old lady afraid to trip over the garden hose or her own feet.
A.R.
Answer: I’m glad you made a distinction between lightheadedness and vertigo. Vertigo is a sensation of movement when there isn’t one. Most commonly, it’s a sensation that the world is spinning, but sometimes the person is spinning, or the movement can be up and down, or side to side.
Lightheadedness, by contrast, is a different feeling, often described by people as though they are going to pass out, which can sometimes happen if a person doesn’t sit down quickly.
Lightheadedness can happen to people at any age, and although it happens to plenty of adolescents, it is much more common in older people.
One of the main reasons for lightheadedness on standing is a relative lack of blood flow to the brain.
The body has powerful mechanisms to maintain blood flow despite the dramatic shift in the pressures required to send blood against the pull of gravity, as well as to keep blood from pooling down in the legs.
These reflexes are a little slower in older people.
I advise people to change position slowly to give the body time to adapt. From lying down, move to a sitting position for a few seconds or a minute before standing up.
Once standing, make sure you are steady before walking.
If you feel lightheaded all the time, not just when you change positions, you should discuss this with your doctor.
You didn’t mention medications, which is one of the most common causes of this problem. Since at least half of older people are taking medications that can affect blood flow and blood pressure, medications are a frequent culprit, but obviously need evaluation before they are adjusted.
There can be many other causes, including heart problems, so this is definitely something to get evaluated if it has not responded to these simple recommendations.