高齢者におけるめまいの背景と対策

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  • 高橋 正紘
    横浜中央クリニック, めまいメニエール病センター

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  • Backgrounds and countermeasures for vertigo/dizziness of elderly people

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<p>　Analyzing databases of 1,599 elderly patients (≧65) who visited my clinic for vertigo/dizziness in the past 9 years and 5 months, I describe herein the causes and backgrounds of, and countermeasures against their symptoms. BPPV and Meniere's disease comprised 74.2% and 16.2%, respectively, having the same values as in all-generation patients; sensorineural hearing loss/tinnitus, central disorders, and decline of vestibular functions were significantly more frequent in the elderly patients. They had various complications: hypertension in 27.5%; orthopedic diseases in 24.5%; insomnia in 23.9%; hyperglycemia in 10.7%; cardiac diseases in 10.3%; diabetes in 7.3%; obesity in 4.3%; cerebral infarction in 3.3%; and respiratory diseases in 2.9%. The incidence of insomnia, orthopedic diseases (women and some men), and cardiac diseases (some men and women) was significantly higher in the elderly patients in this study compared with the general population of the same age group. Although symptoms of BPPV disappeared in 88.5% after 1to 2 visits, a higher proportion of older patients demonstrated more inveterate or recurrent examples. Combinations associated with having retired from the workplace, fatigue, taking sedatives/sleeping drugs, or orthopedic complications impairing these patients' activities of daily living (ADL) resulted in BPPV. Taking medicine was not effective; on the other hand, recommendations to improve the balance of their ADL were effective to improve symptoms and prevent recurrence.</p>

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