Abstract
Background: A cross-sectional observational study was designed to determine the impact of dizziness associated symptoms on the dizziness handicap inventory (DHI) in older adults (≥60 years).Methods: In total, 785 individuals referred to a multidisciplinary dizziness unit were assessed. Participants completed self-report questionnaires with general questions about symptoms of dizziness as well as the DHI. The DHI subscores (physical, functional, emotional) were calculated. Medical diagnoses were collected from the medical records of the patients. One-way MANOVA and networking analysis were used to analyze the impact of dizziness associated symptoms on dizziness handicap.Results: Most patients reported swaying dizziness (60.6%) and feeling of unsteadiness (59.8%) with substantial overlap between the types of dizziness. Most frequent dizziness associated symptoms were ear noise/tinnitus, visual problems, and nausea/vomiting. Network analysis revealed that visual disturbances, headache, and hearing impairment were associated with higher DHI and explained 12% of the DHI variance in the linear regression. In the one-way MANOVA visual problems and headache had an effect on all three DHI subscores, while hearing impairment was associated with the functional and emotional subscores of DHI.Conclusion: Distinct dizziness associated symptoms have substantial impact on dizziness handicap in older adults. A multifactorial assessment including these symptoms may assist in tailoring therapies to alleviate dizziness handicap in this group.
Highlights
Vertigo and dizziness are common complaints in the general population [1]
The patient with the longest time course of symptoms was an 85 year old woman with the diagnosis of vestibular migraine who reported that she had her first episode of spinning vertigo with 6 years of age
Among the studied dizziness associated symptoms (DAS), most patients complained about ear noise/tinnitus and visual disturbances (Figure 2)
Summary
Vertigo and dizziness are common complaints in the general population [1]. According to the International Bárány Society for Neuro-Otology, vertigo and dizziness can be distinguished in that way that “vertigo is the sensation of self-motion when no self-motion is occurring; dizziness is the sensation of disturbed or impaired spatial orientation without a false or distorted sense of motion; and imbalance or unsteadiness is the feeling of being unstable while seated, standing, or walking without a particular directional preference” [2]. Dizziness may have various causes and can occur in peripheral, central, and “higher” vestibular disorders. It is more common in women and in older. The Dizziness Handicap Inventory (DHI) was developed to quantify the self-reported impact of dizziness on daily life [10]. In patients with vestibular disorders aged 65 years or higher, the DHI score has been shown to have a significant association with the Timed Up and Go test and usual gait speed using the timed 10-meter walk test [12]. A cross-sectional observational study was designed to determine the impact of dizziness associated symptoms on the dizziness handicap inventory (DHI) in older adults (≥60 years)
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