Why does my 98-year-old grandmother often feel dizziness?

Question

Hello doctor,

My grandmother is 98 years old. Of late, she is complaining of her head reeling often. She does not have high blood pressure or diabetes, and her haemoglobin is normal. She has roti in the morning, rice and dal for lunch, and roti for dinner. Her bowel movements are normal. What may be the possible reason and line of treatment?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

It is good to see your concern about your grandmother. But one thing you have to keep in mind always is that she belongs to a very fragile age group. Just like the young ones, old people also need special care.

A common condition in this age group is malnutrition, which occurs due to a poor diet. This adds to every other risk factor that can develop in this age group. As per the reports (attachment removed to protect patient identity), there are no abnormalities yet, which is good. However, there can always be some underlying protein deficiency in this age group.

Also, I would suggest you get her serum electrolytes, liver function profile, ECG, and cardiac profile done. Increase the protein content in the diet; you can give egg white as well. Try to divide meals into 5 parts rather than the usual 3 meals a day.

For her headache, I would say, in this age, there could be many reasons for headache, such as reduced vision, refractory errors, glaucoma, anemia, respiratory conditions, etc. Hence, you have to get a detailed assessment done to rule out every cause. For symptomatic improvement, you can give her NSAIDS such as Naproxen, Paracetamol when needed, but avoid repeated usage.

Maintain her hydration, nutrition with high protein content. Once the assessment has been done, it is better to start with some medications, as in this age one should always be cautious.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

Chronic malnutrition can lead to bone depletion, which can lead to fractures. Hence, it is important that an adequate diet is maintained. Also, in this age, caution has to be taken regarding any falls or injuries.

I would suggest the following:

High protein diet.
Adequate calcium in the form of supplements such as milk or milk products.
Vitamin D supplements to improve calcium metabolism.
Adequate support and rest have to be taken.
Avoid vigorous activities at this age.
For pain, NSAIDs can be given when needed.

Thank you.