How to Differentiate Age-Related Dizziness from Neurological Dizziness in the Elderly

At Seoul Jeil Neurology Clinic, we frequently consult with elderly patients who complain of dizziness. However, the term "dizzy" can mean many different things. Is it just due to aging, or is there a problem with the brain or nerves? It can often be confusing. So today, let’s break down how to distinguish between age-related dizziness and neurological causes in a clear and simple way.

1. Types of Dizziness – Start by Understanding the Sensation

When listening to patients describe their symptoms, we typically identify four common types of dizziness sensations. Classifying them can be very helpful in determining the cause.

1️⃣ A spinning sensation – Feeling as if the room is spinning or the body is rotating. This is usually associated with problems in the inner ear (vestibular system) or the brain's vestibular pathways.

2️⃣ A feeling of faintness – Sudden lightheadedness, weakness, and feeling like one might pass out. This often points to orthostatic hypotension or reduced blood flow, potentially from heart-related issues.

3️⃣ A sense of imbalance – Feeling unsteady, especially when walking, as if one might fall. This may result from reduced peripheral sensation, joint problems, or dysfunction in the brain or cerebellum.

4️⃣ A heavy or foggy head – Not clearly spinning or fainting, but feeling mentally clouded, dull, or heavy-headed. This is often linked to medication side effects, metabolic disorders, or mental health stressors.