Hypothesis
Mild age-related vestibular loss (presbyvestibulopathy) explains a meaningful share of dizziness in patients aged 60 and over.
What failed
Among 102 consecutive patients aged 60+ in a subspecialty dizziness clinic, 68.6% had normal vestibular function and only 6.9% had mild bilateral hypofunction. Presbyvestibulopathy was the final diagnosis in just 2.9% (3 patients), and all three had treatable comorbidities such as anxiety.
Broken assumption
Age-related vestibular decline is common enough, and explanatory enough, to account for dizziness in the elderly.
Why
Vestibulo-ocular reflex gain did decline with age (0.96 at 60–69 to 0.77 at 80+, p < 0.001), but most older patients still had normal gains, so the authors conclude a more specific vestibular diagnosis is usually more appropriate.
From the published paper: Chang et al. Frontiers in Neurology, 2026. ↗CC BY