Li Hongyan, Tong Yanping, Wang Yan, Chen Meimei, Cui Yu, Wu Xiaolin, Ju Yi
Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Clinical Center for Vertigo and Balance Disturbance, Capital Medical University, Beijing, China.
Front Neurol. 2025 Apr 24;16:1575816. doi: 10.3389/fneur.2025.1575816. eCollection 2025.
To analyze the clinical characteristics of elderly patients with benign paroxysmal positional vertigo (BPPV), to provide a basis for the accurate diagnosis of elderly BPPV patients.
A retrospective case-control study was conducted to evaluate the clinical data of 12,282 patients diagnosed with BPPV who received treatment at the Vertigo Clinical Diagnosis and Treatment Research Center of Beijing Tiantan Hospital, affiliated with Capital Medical University, between January 2020 and June 2024. Patients were categorized into an elderly group (≥65 years old) and a young-to-middle-aged group (<65 years old). Risk factors, clinical manifestations, and the interval from symptom onset to diagnosis were systematically compared and analyzed.
The mean age of elderly BPPV patients was 71.2 ± 5.4 years, with a male-to-female ratio of approximately 1:2. The posterior semicircular canal was the most commonly affected site (62.3%) in elderly patients, and the incidence of horizontal semicircular canal canalolithiasis was higher in the elderly group compared to the young-to-middle-aged group (16.2% vs. 13.6%, < 0.001). The prevalence of arteriosclerosis-related risk factors (including hypertension, diabetes, hyperlipidemia, and coronary heart disease) was significantly higher ( < 0.001). Elderly patients with BPPV were more likely to experience atypical symptom (40.5% vs. 35.5%, < 0.001), isolated vestibular symptom episodes lasting more than 1 min (23.1% vs. 21.4%, = 0.039), and symptoms accompanied by tinnitus (21.0% vs. 18.8%, = 0.004) and hearing loss (12.7% vs. 8.6%, < 0.001). The proportion of elderly patients whose vertigo was triggered by typical head or body position changes was significantly lower than that in the younger group (35.3% vs. 39.7%, < 0.001). Additionally, the time from symptom onset to diagnosis was positively correlated with age (r = 0.122, < 0.001), and a significantly higher proportion of elderly patients experienced a diagnostic delay exceeding 14 days (35.4% vs. 28.4%, < 0.001).
Elderly patients with BPPV are more likely to present with atypical symptoms, fewer episodes of position-induced vertigo, and a longer symptom duration. Delayed diagnosis is more prevalent among elderly patients.
分析老年良性阵发性位置性眩晕（BPPV）患者的临床特征，为老年BPPV患者的准确诊断提供依据。
进行一项回顾性病例对照研究，评估2020年1月至2024年6月期间在首都医科大学附属北京天坛医院眩晕临床诊疗研究中心接受治疗的12282例确诊为BPPV患者的临床资料。患者分为老年组（≥65岁）和中青年组（<65岁）。系统比较和分析危险因素、临床表现以及从症状发作到诊断的时间间隔。
老年BPPV患者的平均年龄为71.2±5.4岁，男女比例约为1:2。后半规管是老年患者最常受累的部位（62.3%），老年组水平半规管管结石症的发生率高于中青年组（16.2%对13.6%，<0.001）。与动脉硬化相关的危险因素（包括高血压、糖尿病、高脂血症和冠心病）的患病率显著更高（<0.001）。老年BPPV患者更易出现非典型症状（40.5%对35.5%，<0.001）、孤立性前庭症状发作持续超过1分钟（23.1%对21.4%，=0.039）以及伴有耳鸣（21.0%对18.8%，=0.004）和听力损失（12.7%对8.6%，<0.001）的症状。老年患者因典型头部或身体位置变化引发眩晕的比例显著低于年轻组（35.3%对39.7%，<0.001）。此外，从症状发作到诊断的时间与年龄呈正相关（r=0.122，<0.001），且老年患者诊断延迟超过14天的比例显著更高（35.4%对28.4%，<0.001）。
老年BPPV患者更易出现非典型症状、位置性眩晕发作较少且症状持续时间较长。老年患者中延迟诊断更为普遍。
