Fractures & falling

Dizziness


LASA187

Contact: Natasja van Schoor

Background
Dizziness is an important geriatric syndrome that is reported by about 13-30% of people aged over 65 years.1-7 In the United States, it is the most common presenting complaint in general practice among patients aged over 75 years.6 Dizziness has been attributed to many potential causes including vestibular disease, cerebrovascular diseases, cervical spondylosis, carotid hypersensitivity, angina previous myocardial infarction and other cardiac diseases and psychiatric factors.8-10 In addition to cardiovascular disease, cerebrovascular disorders and other neurological diseases, risk factors associated with dizziness in community-based studies, included arthritis, diabetes, alcohol consumption, nervousness, smoking, anxiety, and use of several types of medication,1-3,6,11-12 Dizziness has been associated with an increased risk of institutionalisation, falls, syncope, physical disability and impaired quality of life.1,2,5,6,13-15

Measurement instruments in LASA
Dizziness was assessed during the face-to-face medical interview of LASA C, D, 2B, F, G, H and 3B. To assess dizziness, respondents were first asked whether they are dizzy regularly (yes/no). If a respondent reported regular dizziness, they were asked when (on which moment) they feel dizzy: when getting up, when turning head, when looking up, other reason (i.e. bending down, tension, tiredness, sickness, medication). This question was not asked in LASA H.

Questionnaires
LASAC187 / LASAD187 / LAS2B187 / LASAF187 / LASAG187 / LASAH187 / LAS3B187 (questions mvar700-705; in medical interview, in Dutch) / LASAI187 (in preparation)

Variable information
LASAC187 / LASAD187 / LAS2B187 / LASAF187 / LASAG187 / LASAH187 / LAS3B187
(mvar700-705; pdf) / LASAI187 (not processed yet)

Availability of information per wave1: 

 

B

C

D

E


2B*

F

G

H



3B*

MB*

I*
Dizziness (Y/N)
mvar700
- Me Me - Me Me Me Me Me - Me

Dizziness when?
mvar701-705

-

Me

Me

-

Me

Me

Me

Me

-

-

1 More information about the LASA data collection waves is available on:
http://www.lasa-vu.nl/data/lasa/sampleLASAdatacollection.html

 * 2B=baseline second cohort;
    3B=baseline third cohort;
    MB=migrants: baseline first cohort (Under Construction);
    I=Under Construction

Me=data collected in medical interview

Previous use in LASA
Dizziness has been studied as a predictor for falls in three studies using LASA data. Tromp and colleagues showed that dizziness was not an important predictor for falls after one year (Tromp et al. 2001). However, after three years, dizziness (yes/no) appeared to be an important predictor for falls (Pluijm et al. 2006; Stel et al. 2004). According to pre-defined criteria, it was decided that only predictors with a prevalence of 10% or more were evaluated. Therefore, only the question about dizziness in general was examined as a potential predictor. In addition, preference was given to predictors that were easiest to measure. Therefore, dizziness was included in the final fall risk profiles. In another study, long-term predictors of regular dizziness were examined (Maarsingh et al. 2014).

  • Maarsingh, O.R., Stam, H., Van de Ven, P., Van Schoor , N.M., Ridd, M.J., Van der Wouden, J.C. Predictors of dizziness in older persons: a 10-year prospective cohort study in the community. BMC Geriatrics 2014; 14, 133, 1-7
  • Pluijm, SMF, Smit JH, Tromp EAM, Stel VS, Deeg DJH, Bouter LM, Lips PTA. A risk profile for identifying community-dwelling elderly with a high risk of recurrent falling: results of a 3-year prospective study. Osteoporos Int 2006; 17: 417-25.
  • Stel VS, Pluijm SMF, Deeg DJH, Smit JH, Bouter LM, Lips PTA. Functional limitations and poor physical performance as independent risk factors for self-reported fractures in older persons. Osteoporos Int 2004; 15: 742-50.
  • Tromp AM, Pluijm SMF, Smit JH, Deeg DJH, Bouter LM, Lips PTA. Fall-risk screening test: a prospective study on predictors for falls in community-dwelling elderly. J Clin Epidemiol 2001; 54: 837-44.

References

  1. Tilvis RS, Hakala SM, Valvanne J, Erkinjuntti T. Postural hypotension and dizziness in a general aged population: a four-year follow-up of the Helsinki Aging Study. J Am Geriatr Soc 1996; 44: 809-14.
  2. Ensrud KE, Nevitt MC, Yunis C, Hulley SB, Grimm RH, Cummings SR. Postural hypotension and postural dizziness in elderly women. The study of osteoporotic fractures. The Study of Osteoporotic Fractures Research Group. Arch Intern Med 1992; 152: 1058-64.
  3. Colledge NR, Wilson JA, Macintyre CC, MacLennan WJ. The prevalence and characteristics of dizziness in an elderly community. Age Ageing 1994; 23: 117-20.
  4. Droller H, Pemberton J. Vertigo in a random sample of elderly people living in their own homes. J Laryngol Otol 1953; 67: 689-95.
  5. Sixt E, Landhal S. Postural disturbances in a 75 year old population. I. Prevalence and functional consequences. Age Ageing 1987; 16: 393-8.
  6. Sloane P, Blazer D, George LK. Dizziness in a community elderly population. J Am Geriatr Soc 1989; 37: 101-8.
  7. Grimley Evans J. Transient neurological dysfunction and risk of stroke in an elderly English population: the different significance of vertigo and non-rotatory dizziness. Age Ageing 1990; 19: 43-9.
  8. Colledge NR, Barr-Hamilton RM, Lewis SJ, Sellar RJ, Wilson JA. Evaluation of investigations to diagnose the cause of dizziness in elderly people: a community based controlled study. BMJ 1996; 313: 788-92.
  9. Kroenke K, Lucas CA, Rosenberg ML, Scherokman B, Herbers JE Jr, Wehrle PA, Boggi JO. Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care. Ann Intern Med 1992; 117: 898-904.
  10. Lawson J, Fitzgerald J, Birchall J, Aldren CP, Kenny RA. Diagnosis of geriatric patients with severe dizziness. J Am Geriatr Soc 1999; 47: 12-7.
  11. Sloane PD, Hartman M, Mitchell CM. Psychological factors associated with chronic dizziness in patients aged 60 and older. J Am Geriatr Soc 1994; 42: 847-52.
  12. Tinetti ME, Williams CS, Gill TM. Dizziness among older adults: a possible geriatric syndrome. Ann Intern Med 2000; 132: 337-44.
  13. Grimby A, Rosenhall U. Health-related quality of life and dizziness in old age. Gerontology 1995; 41: 286-98.
  14. Tinetti ME, Speechley M, Ginter SF. Health, functional , and psychological outcomes among older persons with chronic diseases. J Am Geriatr Soc 2000; 48: 417-421.
  15. Graafmans WC, Ooms ME, Hofstee HM, Bezemer PD, Bouter LM, Lips P. Falls in the elderly: a prospective study of risk factors and risk profiles. Am J Epidemiol 1996; 143: 1129-36.