Clinical features of benign paroxysmal positional vertigo in the elderly

Ran Zhou; Huan Wang; Jiachen Shan; Chengcheng Li; Lin Han

doi:10.3389/fneur.2025.1623914

Clinical features of benign paroxysmal positional vertigo in the elderly

Front Neurol. 2025 Jun 16:16:1623914. doi: 10.3389/fneur.2025.1623914. eCollection 2025.

Authors

Ran Zhou^#¹, Huan Wang^#², Jiachen Shan³, Chengcheng Li⁴, Lin Han^{2

5}

Affiliations

¹ Department of Anesthesiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
² Department of Neurology, West China School of Public Health and West China Forth Hospital, Sichuan University, Chengdu, China.
³ Department of Anesthesiology, Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
⁴ Department of Medical Cosmetology, Beijing Ji Shui Tan Hospital, Capital Medical University, Beijing, China.
⁵ Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.

^# Contributed equally.

Abstract

Objectives: The typical age of benign paroxysmal positional vertigo (BPPV) is between 50 and 60 years. With the development of diagnostic techniques and the growth of the elderly, the number of elderly patients has been on the rise gradually. This study compared the clinical characteristics, treatments, and prognoses with patients.

Methods: Patients were divided into two age groups based on age at onset of the disease: middle-aged BPPV (50-59 years) and elderly BPPV (60-80 years old). We compared clinical characteristics, treatment, prognosis, BPPV location, questionnaires between the two groups.

Results: Female patients constituted a high proportion in both the middle-aged BPPV group (21, 75.0%) and the elderly BPPV group (39, 67.2%). The elderly group had significantly higher median scores in the DHI impact than the middle-aged group (24 vs. 16, p = 0.008). In contrast, the BBS score decreased (44 vs. 49, p = 0.019), and the elderly group exhibited higher fall rates (6.9% vs. 0%, p = 0.381) at the last follow-up. However, the elderly BPPV group had lower rates of maneuver (82.8% vs. 89.3%, p = 0.638). Age at onset was positively correlated with the DHI score (r = 0.316, p = 0.005) and negatively correlated with the BBS score (r = -0.330, p = 0.002).

Conclusion: Compared to the middle-aged BPPV group, elderly patients with BPPV exhibited a higher DHI score, increased fall rates, lower BBS scores, and lower rate maneuver, which had a more significant negative impact on daily life.

Keywords: BPPV; balance; benign paroxysmal positional vertigo; elderly; vertigo.