Etiological factor distribution in elderly outpatients with vertigo/dizziness

Abstract

Objective To clarify the distribution of etiological factors in elderly versus non-elderly outpatients with vertigo/dizziness for optimizing the diagnosis and therapy. Methods We retrospectively analyzed data of outpatients with vertigo/dizziness in Shaanxi Provincial People′s Hospital from April 2015 to April 2017 and conducted diagnoses in accordance with the currently wide-accepted diagnostic criteria. Results A total of 3 356 patients with chief complains of vertigo/dizziness were recruited, and their top seven etiological factors were benign paroxysmal positional vertigo(n=1 320, 39.3%), chronic subjective dizziness(n=680, 20.3%), vestibular migraine(n=386, 11.5%), posterior circulation ischemia(n=213, 6.4%), Meniere′s disease(n=138, 4.1%), vestibular neuritis(n=121, 3.6%), and vestibular paroxysmia(n=76, 2.3%). The top four etiological factors for the elderly patients(n=1 255)were benign paroxysmal positional vertigo(n=498, 39.7%), chronic subjective dizziness(n=279, 22.2%), posterior circulation ischemia(n=161, 12.8%), and vestibular migraine(n=73, 5.8%); while the top four etiological factors for non-elderly patients(n=2 101)were benign paroxysmal positional vertigo(n=822, 39.1%), chronic subjective dizziness(n=401, 19.1%), vestibular migraine(n=313, 14.9%), and vestibular neuritis(n=105, 5.0%). The detection rate in elderly patients versus non-elderly patients was significantly higher in chronic subjective dizziness(22.2% vs.19.1%, P=0.032)and in posterior circulation ischemia(12.8% vs.2.5%, P=0.000), and was significantly lower in vestibular neuritis(1.3% vs.5.0%, P= 0.000), in vestibular migraine(5.8% vs.19.4%, P=0.000)and in other causes(1.0% vs.2.7%, P=0.002). Conclusions The ratio of posterior circulation ischemia is markedly higher in elderly outpatients than in non-elderly outpatients, whereas the ratios of vestibular migraine and vestibular neuritis in elderly patients are lower than in non-elderly outpatients. Key words: Vertigo; Dizziness; Etiological factor