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Investigation of self-reported dizziness in the elderly when lying down or turning over in bed, and possible benign paroxysmal positional vertigo

  • E Lindell (a1), T Karlsson (a1), M Johansson (a2), M Magnusson (a3) and C Finizia (a1)...



This study aimed to investigate the rate of dizziness and occurrence of benign paroxysmal positional vertigo in the elderly by physical examination in those reporting dizziness symptoms when lying down or turning over in bed.


A total of 498 people, aged 70–85 years, were asked to complete a questionnaire regarding dizziness symptoms. Subjects answering that they became dizzy in bed were asked to participate in a physical examination and diagnostic manoeuvres investigating benign paroxysmal positional vertigo.


A total of 324 participants (65 per cent) completed the questionnaire. More than one-quarter (29 per cent) reported dizziness and 32 (10 per cent) reported dizziness when turning in bed. Of these 32 persons, 22 (69 per cent) underwent a physical examination. Six participants tested positive for benign paroxysmal positional vertigo.


Ten per cent of the elderly participants reported positional symptoms, and 6 out of 22 fulfilled diagnostic criteria for benign paroxysmal positional vertigo. Furthermore, benign paroxysmal positional vertigo was established despite a delay between questionnaire completion and investigation, emphasising that this type of dizziness may not be a self-limiting disorder.


Corresponding author

Author for correspondence: Dr Ellen Lindell, Department of Otolaryngology, Head and Neck Surgery, Sahlgrenska Universitetssjukhuset, Gröna Stråket 5, 41345 Göteborg, Sweden E-mail:


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Dr E Lindell takes responsibility for the integrity of the content of the paper



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1Ekvall Hansson, E, Mansson, NO, Hakansson, A. Benign paroxysmal positional vertigo among elderly patients in primary health care. Gerontology 2005;51:386–9
2Hanley, K, O'Dowd, T, Considine, N. A systematic review of vertigo in primary care. Br J Gen Pract 2001;51:666–71
3Kollén, L, Horder, H, Moller, C, Frandin, K. Physical functioning in older persons with dizziness: a population-based study. Aging Clin Exp Res 2017;29:197205
4Jonsson, R, Sixt, E, Landahl, S, Rosenhall, U. Prevalence of dizziness and vertigo in an urban elderly population. J Vestib Res 2004;14:4752
5Fernandez, L, Breinbauer, HA, Delano, PH. Vertigo and dizziness in the elderly. Front Neurol 2015;6:144
6Kao, AC, Nanda, A, Williams, CS, Tinetti, ME. Validation of dizziness as a possible geriatric syndrome. J Am Geriatr Soc 2001;49:72–5
7Maarsingh, OR, Dros, J, Schellevis, FG, van Weert, HC, Bindels, PJ, Horst, HE. Dizziness reported by elderly patients in family practice: prevalence, incidence, and clinical characteristics. BMC Fam Pract 2010;11:1910.1186/1471-2296-11-2
8Kollén, L, Frandin, K, Moller, M, Fagevik Olsen, M, Moller, C. Benign paroxysmal positional vertigo is a common cause of dizziness and unsteadiness in a large population of 75-year-olds. Aging Clin Exp Res 2012;24:317–2310.1007/BF03325263
9Grimby, A, Rosenhall, U. Health-related quality of life and dizziness in old age. Gerontology 1995;41:286–98
10Rosso, AL, Eaton, CB, Wallace, R, Gold, R, Stefanick, ML, Ockene, JK et al. Geriatric syndromes and incident disability in older women: results from the Women's Health Initiative Observational Study. J Am Geriatr Soc 2013;61:371–9
11Furman, JM, Cass, SP. Benign paroxysmal positional vertigo. N Engl J Med 1999;341:1590–6
12von Brevern, M, Radtke, A, Lezius, F, Feldmann, M, Ziese, T, Lempert, T et al. Epidemiology of benign paroxysmal positional vertigo: a population based study. J Neurol Neurosurg Psychiatry 2007;78:710–1510.1136/jnnp.2006.100420
13Noda, K, Ikusaka, M, Ohira, Y, Takada, T, Tsukamoto, T. Predictors for benign paroxysmal positional vertigo with positive Dix-Hallpike test. Int J Gen Med 2011;4:809–14
14Mizukoshi, K, Watanabe, Y, Shojaku, H, Okubo, J, Watanabe, I. Epidemiological studies on benign paroxysmal positional vertigo in Japan. Acta Otolaryngol Suppl 1988;447:677210.3109/00016488809102859
15van der Zaag-Loonen, HJ, van Leeuwen, RB, Bruintjes, TD, van Munster, BC. Prevalence of unrecognized benign paroxysmal positional vertigo in older patients. Eur Arch Otorhinolaryngol 2015;272:1521–4
16Oghalai, JS, Manolidis, S, Barth, JL, Stewart, MG, Jenkins, HA. Unrecognized benign paroxysmal positional vertigo in elderly patients. Otolaryngol Head Neck Surg 2000;122:630–410.1016/S0194-5998(00)70187-2
17Craftman, AG, Johnell, K, Fastbom, J, Westerbotn, M, von Strauss, E. Time trends in 20 years of medication use in older adults: findings from three elderly cohorts in Stockholm, Sweden. Arch Gerontol Geriatr 2016;63:2835
18Morin, L, Fastbom, J, Laroche, ML, Johnell, K. Potentially inappropriate drug use in older people: a nationwide comparison of different explicit criteria for population-based estimates. Br J Clin Pharmacol 2015;80:315–2410.1111/bcp.12615
19Haider, SI, Johnell, K, Weitoft, GR, Thorslund, M, Fastbom, J. The influence of educational level on polypharmacy and inappropriate drug use: a register-based study of more than 600,000 older people. J Am Geriatr Soc 2009;57:62–9
20Swedish National Board of Health and Welfare (Socialstyrelsen). Elderly with Regular Medications – Number of Medications as a Risk Marker [in Swedish]. Stockholm: Swedish National Board of Health and Welfare, 2012
21Ziere, G, Dieleman, JP, Hofman, A, Pols, HA, van der Cammen, TJ, Stricker, BH. Polypharmacy and falls in the middle age and elderly population. Br J Clin Pharmacol 2006;61:218–23
22Weidt, S, Bruehl, AB, Straumann, D, Hegemann, SC, Krautstrunk, G, Rufer, M. Health-related quality of life and emotional distress in patients with dizziness: a cross-sectional approach to disentangle their relationship. BMC Health Serv Res 2014;14:317
23Ekwall, A, Lindberg, A, Magnusson, M. Dizzy - why not take a walk? Low level physical activity improves quality of life among elderly with dizziness. Gerontology 2009;55:652–910.1159/000235812
24von Brevern, M, Bertholon, P, Brandt, T, Fife, T, Imai, T, Nuti, D et al. Benign paroxysmal positional vertigo: diagnostic criteria. J Vestib Res 2015;25:105–17
25Dros, J, Maarsingh, OR, van der Horst, HE, Bindels, PJ, Ter Riet, G, van Weert, HC. Tests used to evaluate dizziness in primary care. CMAJ 2010;182:E62131
26Evren, C, Demirbilek, N, Elbistanli, MS, Kokturk, F, Celik, M. Diagnostic value of repeated Dix-Hallpike and roll maneuvers in benign paroxysmal positional vertigo. Braz J Otorhinolaryngol 2017;83:243–8
27Imai, T, Ito, M, Takeda, N, Uno, A, Matsunaga, T, Sekine, K et al. Natural course of the remission of vertigo in patients with benign paroxysmal positional vertigo. Neurology 2005;64:920–1
28Swedish National Board of Health and Welfare (Socialstyrelsen). Indicators of Good Drug Therapy in the Elderly [in Swedish]. Stockholm: Swedish National Board of Health and Welfare, 2017;1106


Investigation of self-reported dizziness in the elderly when lying down or turning over in bed, and possible benign paroxysmal positional vertigo

  • E Lindell (a1), T Karlsson (a1), M Johansson (a2), M Magnusson (a3) and C Finizia (a1)...


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