Skip to main content
Erschienen in: DNP - Der Neurologe & Psychiater 4/2015

07.04.2015 | Zertifizierte Fortbildung

Neurogeriatrie

Schwindel, Dysbalance, Benommenheit und Gangunsicherheit im Alter

verfasst von: Dr. med. Caroline Heinze, Dr. med. Roman Schniepp, Prof. Dr. med. Klaus Jahn

Erschienen in: DNP – Die Neurologie & Psychiatrie | Ausgabe 4/2015

Einloggen, um Zugang zu erhalten

Zusammenfassung

Schwindel ist eines der häufigsten Leitsymptome des älteren Patienten und ist oft durch eine eingeschränkte Aktivität im Alltag und psychiatrische Komorbiditäten charakterisiert. Schwindel im Alter ist ein Komplex einzelner differenzierbarer Funktionsstörungen. Eine ursächliche oder symptomatische Therapie der einzelnen Ursachen führt zu einer gesteigerten Lebensqualität.
Literatur
1.
Zurück zum Zitat Furman JM, Raz Y, Whitney SL. Geriatric vestibulopathy assessment and management. Current opinion in otolaryngology & head and neck surgery. 2010;18(5):386–91.CrossRef Furman JM, Raz Y, Whitney SL. Geriatric vestibulopathy assessment and management. Current opinion in otolaryngology & head and neck surgery. 2010;18(5):386–91.CrossRef
2.
Zurück zum Zitat Tinetti ME, Williams CS, Gill TM. Dizziness among older adults: a possible geriatric syndrome. Annals of internal medicine. 2000;132(5):337–44.CrossRefPubMed Tinetti ME, Williams CS, Gill TM. Dizziness among older adults: a possible geriatric syndrome. Annals of internal medicine. 2000;132(5):337–44.CrossRefPubMed
3.
4.
Zurück zum Zitat Jonsson R, Sixt E, Landahl S, Rosenhall U. Prevalence of dizziness and vertigo in an urban elderly population. Journal of vestibular research: equilibrium & orientation. 2004;14(1):47–52. Jonsson R, Sixt E, Landahl S, Rosenhall U. Prevalence of dizziness and vertigo in an urban elderly population. Journal of vestibular research: equilibrium & orientation. 2004;14(1):47–52.
5.
Zurück zum Zitat Lin HW, Bhattacharyya N. Balance disorders in the elderly: epidemiology and functional impact. The Laryngoscope. 2012;122(8):1858–61.CrossRefPubMed Lin HW, Bhattacharyya N. Balance disorders in the elderly: epidemiology and functional impact. The Laryngoscope. 2012;122(8):1858–61.CrossRefPubMed
6.
Zurück zum Zitat Mueller M, Strobl R, Jahn K, Linkohr B, Peters A, Grill E. Burden of disability attributable to vertigo and dizziness in the aged: results from the KORA-Age study. European journal of public health. 2014;24(5):802–7.CrossRefPubMed Mueller M, Strobl R, Jahn K, Linkohr B, Peters A, Grill E. Burden of disability attributable to vertigo and dizziness in the aged: results from the KORA-Age study. European journal of public health. 2014;24(5):802–7.CrossRefPubMed
7.
Zurück zum Zitat Mueller M, Strobl R, Jahn K, Linkohr B, Ladwig KH, Mielck A, et al. Impact of vertigo and dizziness on self-perceived participation and autonomy in older adults: results from the KORA-Age study. Quality of life research: an international journal of quality of life aspects of treatment, care and rehabilitation. 2014;23(8):2301–8.CrossRef Mueller M, Strobl R, Jahn K, Linkohr B, Ladwig KH, Mielck A, et al. Impact of vertigo and dizziness on self-perceived participation and autonomy in older adults: results from the KORA-Age study. Quality of life research: an international journal of quality of life aspects of treatment, care and rehabilitation. 2014;23(8):2301–8.CrossRef
8.
Zurück zum Zitat Ekwall 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(6):652–9.CrossRefPubMed Ekwall 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(6):652–9.CrossRefPubMed
9.
Zurück zum Zitat de Moraes SA, Soares WJ, Ferriolli E, Perracini MR. Prevalence and correlates of dizziness in community-dwelling older people: a cross sectional population based study. BMC geriatrics. 2013;13:4.CrossRefPubMedCentralPubMed de Moraes SA, Soares WJ, Ferriolli E, Perracini MR. Prevalence and correlates of dizziness in community-dwelling older people: a cross sectional population based study. BMC geriatrics. 2013;13:4.CrossRefPubMedCentralPubMed
10.
Zurück zum Zitat Dros J, Maarsingh OR, Beem L, van der Horst HE, {ter} Riet G, Schellevis FG, et al. Functional prognosis of dizziness in older adults in primary care: a prospective cohort study. Journal of the American Geriatrics Society. 2012;60(12):2263–9.CrossRefPubMed Dros J, Maarsingh OR, Beem L, van der Horst HE, {ter} Riet G, Schellevis FG, et al. Functional prognosis of dizziness in older adults in primary care: a prospective cohort study. Journal of the American Geriatrics Society. 2012;60(12):2263–9.CrossRefPubMed
11.
Zurück zum Zitat Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age and ageing. 2006;35 Suppl 2:ii37–ii41.PubMed Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age and ageing. 2006;35 Suppl 2:ii37–ii41.PubMed
12.
Zurück zum Zitat Agrawal Y, Carey JP, Della Santina CC, Schubert MC, Minor LB. Disorders of balance and vestibular function in US adults: data from the National Health and Nutrition Examination Survey, 2001-2004. Archives of internal medicine. 2009;169(10):938–44.CrossRefPubMed Agrawal Y, Carey JP, Della Santina CC, Schubert MC, Minor LB. Disorders of balance and vestibular function in US adults: data from the National Health and Nutrition Examination Survey, 2001-2004. Archives of internal medicine. 2009;169(10):938–44.CrossRefPubMed
13.
Zurück zum Zitat Boelens C, Hekman EE, Verkerke GJ. Risk factors for falls of older citizens. Technology and health care: official journal of the European Society for Engineering and Medicine. 2013;21(5):521–33. Boelens C, Hekman EE, Verkerke GJ. Risk factors for falls of older citizens. Technology and health care: official journal of the European Society for Engineering and Medicine. 2013;21(5):521–33.
14.
Zurück zum Zitat Kao AC, Nanda A, Williams CS, Tinetti ME. Validation of dizziness as a possible geriatric syndrome. Journal of the American Geriatrics Society. 2001;49(1):72–5.CrossRefPubMed Kao AC, Nanda A, Williams CS, Tinetti ME. Validation of dizziness as a possible geriatric syndrome. Journal of the American Geriatrics Society. 2001;49(1):72–5.CrossRefPubMed
15.
Zurück zum Zitat Whitney SL, Marchetti GF, Schade A, Wrisley DM. The sensitivity and specificity of the Timed „Up & Go“ and the Dynamic Gait Index for self-reported falls in persons with vestibular disorders. Journal of vestibular research: equilibrium & orientation. 2004;14(5):397–409. Whitney SL, Marchetti GF, Schade A, Wrisley DM. The sensitivity and specificity of the Timed „Up & Go“ and the Dynamic Gait Index for self-reported falls in persons with vestibular disorders. Journal of vestibular research: equilibrium & orientation. 2004;14(5):397–409.
16.
Zurück zum Zitat Hotson JR, Baloh RW. Acute vestibular syndrome. The New England journal of medicine. 1998;339(10):680–5.CrossRefPubMed Hotson JR, Baloh RW. Acute vestibular syndrome. The New England journal of medicine. 1998;339(10):680–5.CrossRefPubMed
17.
Zurück zum Zitat Newman-Toker DE, Kerber KA, Hsieh YH, Pula JH, Omron R, Saber Tehrani AS, et al. HINTS outperforms ABCD2 to screen for stroke in acute continuous vertigo and dizziness. Academic emergency medicine: official journal of the Society for Academic Emergency Medicine. 2013;20(10):986–96.CrossRef Newman-Toker DE, Kerber KA, Hsieh YH, Pula JH, Omron R, Saber Tehrani AS, et al. HINTS outperforms ABCD2 to screen for stroke in acute continuous vertigo and dizziness. Academic emergency medicine: official journal of the Society for Academic Emergency Medicine. 2013;20(10):986–96.CrossRef
18.
Zurück zum Zitat Tarnutzer AA, Berkowitz AL, Robinson KA, Hsieh YH, Newman-Toker DE. Does my dizzy patient have a stroke? A systematic review of bedside diagnosis in acute vestibular syndrome. CMAJ: Canadian Medical Association journal = journal de l’Association medicale canadienne. 2011;183(9):E571–92.CrossRef Tarnutzer AA, Berkowitz AL, Robinson KA, Hsieh YH, Newman-Toker DE. Does my dizzy patient have a stroke? A systematic review of bedside diagnosis in acute vestibular syndrome. CMAJ: Canadian Medical Association journal = journal de l’Association medicale canadienne. 2011;183(9):E571–92.CrossRef
19.
Zurück zum Zitat van der Zaag-Loonen HJ, van Leeuwen RB, Bruintjes TD, van Munster BC. Prevalence of unrecognized benign paroxysmal positional vertigo in older patients. European archives of oto-rhino-laryngology: oficial journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS): affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 2014. van der Zaag-Loonen HJ, van Leeuwen RB, Bruintjes TD, van Munster BC. Prevalence of unrecognized benign paroxysmal positional vertigo in older patients. European archives of oto-rhino-laryngology: oficial journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS): affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 2014.
20.
Zurück zum Zitat McClure JA. Horizontal canal BPV. The Journal of otolaryngology. 1985;14(1):30–5.PubMed McClure JA. Horizontal canal BPV. The Journal of otolaryngology. 1985;14(1):30–5.PubMed
21.
Zurück zum Zitat Brandt T, Steddin S. Current view of the mechanism of benign paroxysmal positioning vertigo: cupulolithiasis or canalolithiasis? Journal of vestibular research: equilibrium & orientation. 1993;3(4):373–82. Brandt T, Steddin S. Current view of the mechanism of benign paroxysmal positioning vertigo: cupulolithiasis or canalolithiasis? Journal of vestibular research: equilibrium & orientation. 1993;3(4):373–82.
22.
Zurück zum Zitat Bachor E, Wright CG, Karmody CS. The incidence and distribution of cupular deposits in the pediatric vestibular labyrinth. The Laryngoscope. 2002;112(1):147–51.CrossRefPubMed Bachor E, Wright CG, Karmody CS. The incidence and distribution of cupular deposits in the pediatric vestibular labyrinth. The Laryngoscope. 2002;112(1):147–51.CrossRefPubMed
23.
Zurück zum Zitat Vibert D, Kompis M, Hausler R. Benign paroxysmal positional vertigo in older women may be related to osteoporosis and osteopenia. The Annals of otology, rhinology, and laryngology. 2003;112(10):885–9.CrossRefPubMed Vibert D, Kompis M, Hausler R. Benign paroxysmal positional vertigo in older women may be related to osteoporosis and osteopenia. The Annals of otology, rhinology, and laryngology. 2003;112(10):885–9.CrossRefPubMed
24.
Zurück zum Zitat Brandt T, Huppert D, Hecht J, Karch C, Strupp M. Benign paroxysmal positioning vertigo: a long-term follow-up (6-17 years) of 125 patients. Acta oto-laryngologica. 2006;126(2):160–3.CrossRefPubMed Brandt T, Huppert D, Hecht J, Karch C, Strupp M. Benign paroxysmal positioning vertigo: a long-term follow-up (6-17 years) of 125 patients. Acta oto-laryngologica. 2006;126(2):160–3.CrossRefPubMed
25.
Zurück zum Zitat Zingler VC, Cnyrim C, Jahn K, Weintz E, Fernbacher J, Frenzel C, et al. Causative factors and epidemiology of bilateral vestibulopathy in 255 patients. AnnNeurol. 2007;61(6):524–32. Zingler VC, Cnyrim C, Jahn K, Weintz E, Fernbacher J, Frenzel C, et al. Causative factors and epidemiology of bilateral vestibulopathy in 255 patients. AnnNeurol. 2007;61(6):524–32.
26.
Zurück zum Zitat Migliaccio AA, Halmagyi GM, McGarvie LA, Cremer PD. Cerebellar ataxia with bilateral vestibulopathy: description of a syndrome and its characteristic clinical sign. Brain: a journal of neurology. 2004;127(Pt 2):280–93.CrossRef Migliaccio AA, Halmagyi GM, McGarvie LA, Cremer PD. Cerebellar ataxia with bilateral vestibulopathy: description of a syndrome and its characteristic clinical sign. Brain: a journal of neurology. 2004;127(Pt 2):280–93.CrossRef
27.
Zurück zum Zitat Szmulewicz DJ, Waterston JA, MacDougall HG, Mossman S, Chancellor AM, McLean CA, et al. Cerebellar ataxia, neuropathy, vestibular areflexia syndrome (CANVAS): a review of the clinical features and video-oculographic diagnosis. Annals of the New York Academy of Sciences. 2011;1233:139–47.CrossRefPubMed Szmulewicz DJ, Waterston JA, MacDougall HG, Mossman S, Chancellor AM, McLean CA, et al. Cerebellar ataxia, neuropathy, vestibular areflexia syndrome (CANVAS): a review of the clinical features and video-oculographic diagnosis. Annals of the New York Academy of Sciences. 2011;1233:139–47.CrossRefPubMed
28.
Zurück zum Zitat Schniepp R, Wuehr M, Neuhaeusser M, Benecke AK, Adrion C, Brandt T, et al. 4-aminopyridine and cerebellar gait: a retrospective case series. Journal of neurology. 2012;259(11):2491–3.CrossRefPubMed Schniepp R, Wuehr M, Neuhaeusser M, Benecke AK, Adrion C, Brandt T, et al. 4-aminopyridine and cerebellar gait: a retrospective case series. Journal of neurology. 2012;259(11):2491–3.CrossRefPubMed
29.
Zurück zum Zitat Wuehr M, Schniepp R, Schlick C, Huth S, Pradhan C, Dieterich M, et al. Sensory loss and walking speed related factors for gait alterations in patients with peripheral neuropathy. Gait & posture. 2014;39(3):852–8.CrossRef Wuehr M, Schniepp R, Schlick C, Huth S, Pradhan C, Dieterich M, et al. Sensory loss and walking speed related factors for gait alterations in patients with peripheral neuropathy. Gait & posture. 2014;39(3):852–8.CrossRef
30.
Zurück zum Zitat Hillier SL, McDonnell M. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Clinical otolaryngology: official journal of ENT-UK; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery. 2011;36(3):248–9.CrossRef Hillier SL, McDonnell M. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Clinical otolaryngology: official journal of ENT-UK; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery. 2011;36(3):248–9.CrossRef
31.
Zurück zum Zitat Dieterich M, Brandt T. Ocular torsion and tilt of subjective visual vertical are sensitive brainstem signs. Annals of neurology. 1993;33(3):292–9.CrossRefPubMed Dieterich M, Brandt T. Ocular torsion and tilt of subjective visual vertical are sensitive brainstem signs. Annals of neurology. 1993;33(3):292–9.CrossRefPubMed
32.
Zurück zum Zitat Ghosh BC, Carpenter RH, Rowe JB. A longitudinal study of motor, oculomotor and cognitive function in progressive supranuclear palsy. PloS one. 2013;8(9):e74486.CrossRefPubMedCentralPubMed Ghosh BC, Carpenter RH, Rowe JB. A longitudinal study of motor, oculomotor and cognitive function in progressive supranuclear palsy. PloS one. 2013;8(9):e74486.CrossRefPubMedCentralPubMed
33.
Zurück zum Zitat Bense S, Best C, Buchholz HG, Wiener V, Schreckenberger M, Bartenstein P, et al. 18F-fluorodeoxyglucose hypometabolism in cerebellar tonsil and flocculus in downbeat nystagmus. Neuroreport. 2006;17(6):599–603.CrossRefPubMed Bense S, Best C, Buchholz HG, Wiener V, Schreckenberger M, Bartenstein P, et al. 18F-fluorodeoxyglucose hypometabolism in cerebellar tonsil and flocculus in downbeat nystagmus. Neuroreport. 2006;17(6):599–603.CrossRefPubMed
34.
Zurück zum Zitat Kalla R, Glasauer S, Schautzer F, Lehnen N, Buttner U, Strupp M, et al. 4-aminopyridine improves downbeat nystagmus, smooth pursuit, and VOR gain. Neurology. 2004;62(7):1228–9.CrossRefPubMed Kalla R, Glasauer S, Schautzer F, Lehnen N, Buttner U, Strupp M, et al. 4-aminopyridine improves downbeat nystagmus, smooth pursuit, and VOR gain. Neurology. 2004;62(7):1228–9.CrossRefPubMed
35.
Zurück zum Zitat Strupp M, Kalla R, Glasauer S, Wagner J, Hufner K, Jahn K, et al. Aminopyridines for the treatment of cerebellar and ocular motor disorders. Progress in brain research. 2008;171:535–41.CrossRefPubMed Strupp M, Kalla R, Glasauer S, Wagner J, Hufner K, Jahn K, et al. Aminopyridines for the treatment of cerebellar and ocular motor disorders. Progress in brain research. 2008;171:535–41.CrossRefPubMed
36.
Zurück zum Zitat Zijlstra GA, van Haastregt JC, van Eijk JT, van Rossum E, Stalenhoef PA, Kempen GI. Prevalence and correlates of fear of falling, and associated avoidance of activity in the general population of community-living older people. Age and ageing. 2007;36(3):304–9.CrossRefPubMed Zijlstra GA, van Haastregt JC, van Eijk JT, van Rossum E, Stalenhoef PA, Kempen GI. Prevalence and correlates of fear of falling, and associated avoidance of activity in the general population of community-living older people. Age and ageing. 2007;36(3):304–9.CrossRefPubMed
37.
Zurück zum Zitat van Haastregt JC, Zijlstra GA, van Rossum E, van Eijk JT, Kempen GI. Feelings of anxiety and symptoms of depression in community-living older persons who avoid activity for fear of falling. The American journal of geriatric psychiatry: official journal of the American Association for Geriatric Psychiatry. 2008;16(3):186–93.CrossRef van Haastregt JC, Zijlstra GA, van Rossum E, van Eijk JT, Kempen GI. Feelings of anxiety and symptoms of depression in community-living older persons who avoid activity for fear of falling. The American journal of geriatric psychiatry: official journal of the American Association for Geriatric Psychiatry. 2008;16(3):186–93.CrossRef
38.
Zurück zum Zitat Zwergal A, Linn J, Xiong G, Brandt T, Strupp M, Jahn K. Aging of human supraspinal locomotor and postural control in fMRI. Neurobiology of aging. 2012;33(6):1073–84.CrossRefPubMed Zwergal A, Linn J, Xiong G, Brandt T, Strupp M, Jahn K. Aging of human supraspinal locomotor and postural control in fMRI. Neurobiology of aging. 2012;33(6):1073–84.CrossRefPubMed
39.
Zurück zum Zitat Kendrick D, Kumar A, Carpenter H, Zijlstra GA, Skelton DA, Cook JR, et al. Exercise for reducing fear of falling in older people living in the community. The Cochrane database of systematic reviews. 2014;11:Cd009848.PubMed Kendrick D, Kumar A, Carpenter H, Zijlstra GA, Skelton DA, Cook JR, et al. Exercise for reducing fear of falling in older people living in the community. The Cochrane database of systematic reviews. 2014;11:Cd009848.PubMed
Metadaten
Titel
Neurogeriatrie
Schwindel, Dysbalance, Benommenheit und Gangunsicherheit im Alter
verfasst von
Dr. med. Caroline Heinze
Dr. med. Roman Schniepp
Prof. Dr. med. Klaus Jahn
Publikationsdatum
07.04.2015
Verlag
Urban & Vogel
Erschienen in
DNP – Die Neurologie & Psychiatrie / Ausgabe 4/2015
Print ISSN: 2731-8168
Elektronische ISSN: 2731-8176
DOI
https://doi.org/10.1007/s15202-015-0584-0

Weitere Artikel der Ausgabe 4/2015

DNP - Der Neurologe & Psychiater 4/2015 Zur Ausgabe