Dizziness in older adults is usually caused by more than one thing at once. The common contributors are inner-ear disorders, blood pressure dropping on standing, medication side effects, reduced vision, neuropathy affecting the feet, and heart rhythm problems.
Dizziness in older adults is usually caused by more than one thing at once. The common contributors are inner-ear disorders, blood pressure dropping on standing, medication side effects, reduced vision, neuropathy affecting the feet, and heart rhythm problems.
Balance depends on the inner ear, vision, sensation from the feet and legs, and the brain integrating all three. In older adults it is common for two or three of those to be mildly impaired at the same time, and the combination produces symptoms that none would cause alone. That is why looking for a single explanation often fails, and why treating two modest contributors can produce a bigger improvement than chasing one dramatic diagnosis.
Blood pressure medication, sedatives, antidepressants, antihistamines, some bladder medications and anything with anticholinergic effects all contribute. So does the total number of medications, independent of which ones. This is the most reversible contributor and the one most often overlooked, which is why bringing a complete list including over-the-counter items and supplements to the appointment matters more here than almost anywhere else in neurology.
Distinguishing the sensations helps: true spinning suggests the inner ear, light-headedness on standing suggests blood pressure, and unsteadiness without spinning suggests a sensory or neurological cause. Blood pressure is measured lying and standing. Sensation in the feet is tested, since neuropathy is a frequent contributor and treatable causes exist. VNG balance testing is performed at both CNS offices where inner-ear assessment is indicated. Falls risk is addressed alongside the diagnosis, because the consequence matters as much as the cause.
Clinical Neurology Specialists has been physician-owned since 1998, when Leo Germin, M.D., FAANEM founded it. Five board-certified neurologists and four advanced practice providers see patients at the Las Vegas and Henderson offices, each with its own AANEM-accredited electrodiagnostic laboratory.
Clinical Neurology Specialists is an adult outpatient neurology practice for patients 18 and older. The practice performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no emergency or inpatient care.
Physician-reviewed. Reviewed by the physicians of Clinical Neurology Specialists — board-certified neurologists, AANEM-accredited electrodiagnostic laboratories, physician-owned since 1998. Reviewed 1 August 2026. This article is general education for adults 18 and older and is not a substitute for a consultation.
Sources and further reading: MedlinePlus, National Library of Medicine; National Institute of Neurological Disorders and Stroke; National Institute on Aging.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.