Why does BPPV occur more Often as we Age?

By Cheryl Wylie, MSc (PT)

Benign Paroxysmal Positional Vertigo (BPPV) is a common disorder of the inner ear that leads to brief episodes of vertigo (a spinning sensation) triggered by specific changes in head position. While BPPV can affect individuals of any age, it is true that it tends to occur more frequently in older adults. In fact, 10% of people over the age of 65 will experience BPPV at some point in their life.

There are several reasons why BPPV may be more common as people age:

1. Changes in the Inner Ear: The inner ear structures, including the vestibular system responsible for balance, may undergo age-related changes. These changes can make the inner ear more susceptible to the displacement of calcium carbonate crystals (otoconia) that contribute to BPPV.

2. Degeneration of Otolith Organs: The otolith organs in the inner ear (utricle and saccule) contain the otoconia (crystals) responsible for sensing gravity and linear acceleration. Age-related degeneration or changes in these organs may increase the likelihood of otoconia becoming dislodged and entering the semicircular canals, where they can trigger vertigo.

3. Sedentary Lifestyle: BPPV occurs when the otoconia enter the semicircular canals. The easiest way this occurs is when we are lying down or reclined. A sedentary lifestyle which involves more time in bed or on the couch has been linked to increased rates of BPPV. 

4. Other Age-Related Conditions: Older adults are more likely to experience other conditions that can contribute to BPPV, such as vascular issues, osteoporosis, or changes in calcium metabolism.

5. Cumulative Effects of Microtrauma: Over time, microtrauma or cumulative damage to the inner ear structures may occur due to various factors, including head injuries, changes in blood supply, or repetitive head movements. These factors can increase the risk of otoconia displacement.

It's important to note that while BPPV is more common in older adults, it can still affect individuals of any age. The characteristic symptoms include brief episodes of vertigo triggered by specific head movements, such as rolling over in bed or tilting the head backward. Fortunately, BPPV is a treatable condition, often managed through a series of specific head movements (canalith repositioning maneuvers) performed by vestibular physiotherapist and other trained healthcare professionals. Vestibular Physiotherapists at Healing Vertigo are highly trained to treat BPPV and can do so in-person or virtually. The Healing Vertigo App is a resource tool that can be used if you have already undergone BPPV treatment and are looking to manage any recurrences on your own. 

Click here to learn more about BPPV.