P 29. Age-associated characteristics in chronic vertigo patients: A survey of a specialized center for vertigo and dizziness

Abstract

Introduction. Dizziness and vertigo are among the most important leading symptoms in everyday medical practice. They often become chronic and regularly lead to significant distress with a considerably limited quality of life. Considering the demographic change, the already increased prevalence of vertigo/dizziness in older people will continue to increase progressively in the near future. Therefore, it is necessary to optimize diagnosis and therapy of chronic vertigo patients. Methods. The study included 1.752 patients with chronic vertigo/dizziness who were undergoing treatment at our specialized center for dizziness and vertigo in the period from January 2013 to November 2017. The data was collected based on a questionnaire and analysis of associated patient records. Information concerning age, gender, vertigo-appearance, diagnosis, diagnostics and therapies of all patients are included. Furthermore, the Dizziness Handicap Inventory (DHI) was used to quantitatively measure the level of vertigo and dizziness impairment. Using descriptive statistics, the collected data was finally analyzed and interpreted concerning to three different age groups (age group I < 41, age group II = 41–65, age group III > 65 years of age). Results. In participants of older age, primarily somatic deficits determined the genesis of vertigo, whereas disorders in younger participants were mostly due to psychological processes. For instance, more than 80% of patients over 65 years of age had vertigo of somatic cause and in more than 50% of those under 41 years of age vertigo was based on psychological reasons (Fig. 1). Furthermore, a steady increase in vertigo impairment with advancing age was shown, which couldn“t be reasonably justified by pathogenesis or the symptomatic manifestation of the disease. Therefore, it is more likely that age-related physiological degeneration of the vestibular system as well as cognitive restrictions limit the possibilities of compensation and thus increase the level of suffering from vertigo. In addition, older patients surprisingly were less frequently affected by accompanying symptoms such as nausea/vomiting, headache, ear pressure, tinnitus and visual impairment than younger patients. Conclusion. For the interdisciplinary day care approach a combination of physiotherapy, occupational therapy as well as cognitive-based behavioral therapy is recommended. Our data suggest the assignment of patients to age-specific therapy groups. Further, because of its more frequent occurrence, symptomatic therapy of accompanying symptoms should be intensified in younger patients. Moreover, the recruitment of potential vertigo patients based on the DHI has proven to be convincing. Fig. 1. Classification and distribution of vertigo/dizziness according to somatic, psychogenic or unspecific origin in different age groups.