At what age do people develop vertigo? An Expert's Guide

According to Balance & Dizziness Canada, dizziness accounts for 75% of physician visits for individuals over 65, and over 60% of people over 80 will have seen a doctor for dizziness. This increase in prevalence leads many to ask, 'At what age do people develop vertigo?' The reality is more complex, as vertigo can affect individuals from childhood to old age, though the underlying causes and frequency often change throughout life.

Quick Summary

Vertigo can emerge at any age, from childhood to older adulthood, though its most common causes, like Benign Paroxysmal Positional Vertigo (BPPV), occur with increasing frequency after age 50. Other causes, such as Ménière's disease, typically affect those between 40 and 60, while childhood vertigo is also a possibility.

Key Points

• Prevalence increases with age: While vertigo can occur at any age, its frequency significantly increases, particularly after age 50.

• Common causes vary by life stage: The underlying reasons for vertigo differ from childhood (e.g., benign paroxysmal vertigo of childhood) to middle age (e.g., Ménière's disease) and older adulthood (e.g., BPPV).

• Most common vertigo type peaks in older adults: Benign Paroxysmal Positional Vertigo (BPPV) is the most frequent cause and affects adults over 50 more often due to age-related inner ear changes.

• Vertigo in older adults increases health risks: For seniors, vertigo not only reduces quality of life but also significantly increases the risk of falls, a leading cause of injury.

• Proper diagnosis is key for treatment: Since causes vary, seeing a healthcare professional is essential for an accurate diagnosis and to receive the correct treatment, which may include maneuvers, medication, or therapy.

• Underlying conditions play a role: Many medical conditions and medications common in older adults can contribute to or cause vertigo, adding to its prevalence in this population.

Understanding Vertigo and Its Causes

Vertigo is not a disease itself but a symptom—a false sensation of motion, like spinning or tilting. It originates from issues within the vestibular system, which includes the inner ear and parts of the brain that help control balance. There are two main types: peripheral vertigo, caused by inner ear issues, and central vertigo, which results from a problem in the brain. The age at which vertigo first appears can often provide clues about its specific cause.

Benign Paroxysmal Positional Vertigo (BPPV)

Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of vertigo and is strongly associated with older age. BPPV occurs when tiny calcium carbonate crystals (otoconia) dislodge from their normal position in the inner ear and move into the semicircular canals. This sends confusing signals to the brain, triggering brief, intense episodes of vertigo with specific head movements.

• Prevalence by Age: While it can occur at any age, BPPV becomes significantly more common with advancing years. It is most frequent in people aged 50 and older.
• Underlying Reason: The age-related increase in BPPV is often due to the degeneration of the inner ear tissues. The crystals become less dense and more varied in size, and their replacement process slows down, increasing the likelihood of them breaking loose.

Vestibular Neuritis and Labyrinthitis

These are inner ear infections that cause inflammation of the vestibular nerve (vestibular neuritis) or the inner ear labyrinth (labyrinthitis). These conditions can strike at any point in adulthood, but some data suggest a peak incidence in middle age.

• Vestibular Neuritis: An epidemiological survey in Japan reported the peak age distribution for this condition was between 40 and 50 years. The onset is often sudden and can lead to severe vertigo that can last for days.
• Labyrinthitis: This condition can also cause vertigo alongside hearing problems and can affect people of various ages, particularly following a viral infection.

Ménière's Disease

Ménière's disease is another inner ear disorder that causes sudden attacks of severe vertigo, often accompanied by fluctuating hearing loss, ringing in the ears (tinnitus), and a feeling of fullness in the ear. The age of onset is more specific than with other types of vertigo.

• Typical Age of Onset: This condition is most common in individuals between 40 and 60 years old. However, it can also appear in older age, sometimes as a reactivation of a longstanding condition.

Childhood Vertigo

Vertigo is less common in children but is a possibility, though young children may have difficulty describing the sensation. For them, it might present as clumsiness, nausea, or rapid, darting eye movements (nystagmus).

• Benign Paroxysmal Vertigo of Childhood: The most common type of childhood vertigo, these episodes can begin as early as age 2 or 3 and often resolve by age 8. Sometimes, this can be a precursor to migraine in later childhood.
• Ear Infections: Inner ear infections are a frequent cause of vertigo in children, often resolving once the infection is treated.

Age-Related Factors and Risk Increases

As the body ages, several factors can increase the likelihood of experiencing vertigo and related balance issues.

• Degeneration of the Vestibular System: Like other systems, the inner ear's balance components can decline with age. The tissues and systems that help maintain balance deteriorate, making older adults more susceptible to conditions like BPPV.
• Comorbidities: Older individuals are more likely to have other medical conditions that can cause or contribute to dizziness and imbalance, such as diabetes, cardiovascular disease, or neurological conditions like Parkinson's disease.
• Medications: Many medications commonly prescribed for older adults can have dizziness and balance issues as a side effect. This can further complicate and increase the risk of vertigo attacks.
• Increased Risk of Falls: For older adults, vertigo is not just uncomfortable; it also significantly increases the risk of falls, a leading cause of injuries and death in this population.

Comparison of Vertigo by Age Group

Feature	Childhood	Middle Age (40-60)	Older Adulthood (50+)
Common Causes	Benign Paroxysmal Vertigo of Childhood, Ear Infections, Vestibular Migraine	Ménière's Disease, Vestibular Neuritis, BPPV	BPPV, Age-related vestibular degeneration, Comorbidities, Medication Side Effects
Symptom Duration	Episodes often brief and self-resolving, usually ending by age 8.	Can be persistent or episodic (Ménière's), lasting for weeks or months in some cases.	Episodes (BPPV) are brief but recur. Chronic dizziness and imbalance are more common.
Impact	Frightening for the child, can be mistaken for other issues like seizures.	Significantly disruptive to daily life, can impact work and social activities.	Increased risk of falls and injury, reduced independence, and impaired quality of life.
Triggering Factors	Often spontaneous or related to infection.	Often without a known cause, though stress or diet may play a role.	Head movement (BPPV), general age-related decline, medication effects.

Addressing Vertigo at Any Age

Regardless of age, a proper diagnosis from a healthcare professional is crucial to determine the specific cause of vertigo. For BPPV, simple repositioning maneuvers performed by a doctor or physical therapist can resolve symptoms by moving the dislodged crystals back into place. For other conditions, management may involve medication, lifestyle adjustments, or vestibular rehabilitation therapy to help the brain compensate for inner ear dysfunction. You can learn more about balance disorders from the Vestibular Disorders Association.

Conclusion

While the answer to "At what age do people develop vertigo?" is not a single number, the pattern is clear. Vertigo can affect anyone, but the likelihood and the specific causes shift throughout life. From the benign episodes of childhood to the peak incidence of BPPV in older adults, understanding the age-related factors is vital for diagnosis and effective management. With proper medical attention, people of all ages can find relief and regain their balance.

Frequently Asked Questions

Can vertigo affect children?

Yes, vertigo can affect children, though it is less common than in adults. Causes can include benign paroxysmal vertigo of childhood, ear infections, or vestibular migraines. The symptoms might be harder to describe for a child, often appearing as clumsiness or unsteadiness.

Is vertigo a normal part of aging?

Vertigo is not a normal part of aging, but certain age-related factors can increase a person's risk. The prevalence increases significantly with age, largely due to the higher incidence of conditions like BPPV and age-related decline of the vestibular system.

What is the most common age for BPPV?

Benign Paroxysmal Positional Vertigo (BPPV), the most common form of vertigo, is most prevalent in individuals aged 50 and older. Its occurrence is often linked to the natural degradation of inner ear tissues with age.

How does vertigo differ in younger vs. older adults?

The key difference lies in the causes. Younger adults and children may experience vertigo due to inner ear infections (like labyrinthitis), head injuries, or conditions like Ménière's disease (typically starting in middle age). For older adults, BPPV and age-related vestibular decline are more common causes.

Does vertigo increase the risk of falls in older adults?

Yes, for older adults, vertigo is a significant risk factor for falls. The sensation of spinning and imbalance can cause unsteadiness, leading to serious injuries. Fall prevention is a major concern when treating vertigo in this population.

Can certain medications cause vertigo in older people?

Yes, older adults often take multiple medications, and some can have side effects that cause dizziness or imbalance, which can trigger or worsen vertigo. It is important to review all medications with a doctor to identify potential culprits.

What are some treatment options for age-related vertigo?

Treatment depends on the cause. For BPPV, a physician or physical therapist can perform repositioning maneuvers (like the Epley maneuver) to correct the inner ear crystals. For other causes, treatment may involve medication, vestibular rehabilitation therapy, or addressing underlying health conditions.