Citation

Menant JC, Wong A, Sturnieks DL, Close JC, Delbaere K, Sachdev PS, Brodaty H, Lord SR. J. Am. Geriatr. Soc. 2013; 61(3): 423-428.

Affiliation

Falls and Balance Research Group, Neuroscience Research Australia, Randwick, New South Wales, Australia; School of Public Health and Community Medicine, University of New South Wales, New South Wales, Australia.

Copyright

(Copyright © 2013, John Wiley and Sons)

DOI

10.1111/jgs.12131

PMID

23351026

Abstract

OBJECTIVES: To identify medical, psychological, and physiological mediators of the relationship between dizziness and falls in older adults. DESIGN: Secondary analysis of a prospective cohort study. SETTING: Community. PARTICIPANTS: Five hundred sixteen community-dwelling adults aged 73 to 92. MEASUREMENTS: Participants completed questionnaires related to health and psychological well-being and underwent a tilt table blood pressure test, the Physiological Profile Assessment (PPA; vision, reaction time, proprioception, postural sway, and quadriceps strength), and leaning balance tests. Prospective falls data were collected using monthly calendars for 12 months. Participants were categorized into dizzy and nondizzy groups based on self-report of dizziness, vertigo, and light-headedness. RESULTS: Two hundred seventeen (42%) participants reported vertigo or dizziness (10%), light-headedness (16%), or both (16%). The dizzy participants were significantly more likely to report neck and back pain, past transient ischemic attacks, and feeling dizzy upon upright tilting. They also had poorer balance and less strength and scored higher on measures of depression and anxiety (P < .05). There were no blood pressure measurement-related differences between the groups. Dizziness increased the risk of multiple falls in an unadjusted analysis (relative risk (RR) = 1.55, 95% confidence interval = 1.08-2.23). After controlling for PPA scores, neck and back pain and anxiety were mediators that reduced the RR of the relationship between dizziness and faller status the most (14%) in a modified Poisson regression model. CONCLUSION: Suffering from neck and back pain and anxiety were mediators of the relationship between dizziness and falls after controlling for poor sensorimotor function and balance. Older people with dizziness might benefit from interventions targeting these mediators such as pain management and cognitive behavioral therapy.

Language: en