Inner‑ear crystals often to blame for sudden dizzy spells, doctor says; other common health tips for older adults

Benign paroxysmal positional vertigo (BPPV) is a common and treatable cause of sudden, severe dizziness triggered by head movements, a physician writing in a Sept. 15 health column said.

Patients typically describe a spinning sensation when getting out of bed, rolling over, looking up or bending down. The vertigo itself usually lasts for a minute or so but can be accompanied by longer bouts of nausea or vomiting and a lingering unsteadiness between attacks.

BPPV occurs when tiny calcium carbonate crystals that normally sit within the inner ear become dislodged and move into canals that sense head position. When these particles shift with head movement they stimulate hair cells and send disruptive signals to the brain, producing a sensation similar to seasickness. The condition can follow inner‑ear inflammation such as labyrinthitis, a fall or sports injury, and some research has linked it to low vitamin D, which affects calcium metabolism.

The recommended first‑line treatment is the Epley manoeuvre, a series of targeted head and body movements designed to guide the crystals back to their proper location. Many general practitioners and physiotherapists can perform or teach the technique, and it is often effective. For immediate relief of motion‑sickness symptoms, short‑term medications can be used. Doctors may also test for vitamin D deficiency in patients with recurrent episodes, since supplementation has been shown in some studies to reduce recurrence.

Although BPPV is considered benign in the sense that it is not life threatening, it can substantially affect quality of life and increase the risk of falls and injury. Physicians advise patients who experience recurrent or severe dizziness to see their GP and ask about referral to a neurotologist, a specialist in inner‑ear and balance disorders.

In the same column, the physician addressed erectile difficulties in older men, noting age as the strongest risk factor. Studies indicate that a large proportion of men in their 70s and 80s experience some degree of erectile dysfunction. Contributing factors include age‑related changes to blood vessels and nerves, lower testosterone levels and psychological factors such as anxiety about sexual performance.

Medication interactions do not always explain erectile problems. The physician noted that statins have been associated with small improvements in erectile function in some analyses. For men without contraindications, phosphodiesterase type 5 inhibitors such as tadalafil may be discussed with a GP; tadalafil can facilitate an erection for a longer window than sildenafil and does not typically interact with common cardiovascular medicines, though individual assessment is required. Clinicians also commonly check blood sugar to screen for diabetes, which can damage nerves key to erection, and measure testosterone; supplementation may help if levels are low but is not beneficial when testosterone is within the normal range.

The column also highlighted respiratory syncytial virus (RSV) as a recurrent seasonal concern. RSV is highly contagious and can cause croup in young children and respiratory infections in older adults, with complications including pneumonia. Treatment for croup has shifted away from home remedies such as steam; a single oral dose of the corticosteroid dexamethasone has become standard care for reducing airway inflammation.

Regulatory trials have shown that an RSV vaccine for adults aged 75 and older can reduce hospital admissions by about 82 percent. Health professionals urge eligible older adults to discuss the vaccine with their primary care practice, particularly when they receive their annual influenza vaccination.

Patients experiencing new, recurrent or dangerous symptoms—such as sudden severe vertigo, unexplained changes in sexual function, or acute breathing difficulties—should seek assessment from their GP. Medical evaluation can identify treatable causes and direct patients to appropriate specialists or interventions.