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DETERMINANTS OF DIZZINESS IN THE ELDERLY: A CROSS-SECTIONAL STUDY
Bliek B van den, Kerskes M, Egberts A, Maas H
DETERMINANTS OF DIZZINESS IN THE ELDERLY: A CROSS-SECTIONAL STUDY
Bliek B van den(1), Kerskes M(2), Egberts A(2) Maas H(1)
1) Department of Geriatric Medicine, TweeSteden hospital, Tilburg, The Netherlands
2) Department of Clinical Pharmacy, TweeSteden hospital and St Elisabeth Hospital, Tilburg, The Netherlands
Purpose: Dizziness is a frequently encountered, disabling problem in elderly patients. The etiology of dizziness in elderly patients is largely unknown. The objective of the present study is to determine predisposing patient characteristics associated with dizziness in the elderly.
Methods: We included 43 patients with dizziness and 47 patients without dizziness on the geriatric outpatient department. Patients with cognitive decline (MMSE less than18) or patients bound to a wheelchair were excluded. For all patients we assessed medical history, drug use, functional status (vision, hearing, mobility), ECG, postural hypotension, anxiety, depression and cognitive status. Dizziness Handicap Inventory (DHI) was used to assess the influence of dizziness on daily living.
Results: Characteristics associated with dizziness with univariate analysis were: female gender, age above 80, ECG abnormalities, postural hypotension, depressive symptoms, impaired mobility, vision impairment and the use of benzodiazepines, analgetics (tramadol and codein) and nitrates. Multivariate analysis showed that postural hypotension (OR 5.6 (1.4-22.9)), ECG abnormalities (OR 6.1 (1.6-23.0)), female gender (OR 7.5 (2.0-28.4) and vision impairment (OR 3.3 (1.2-9.2)) were significantly and independently associated with dizziness. Increasing DHI-scores were associated with a higher presence of these patient characteristics (R2 = 0.19).
Conclusion: Patient characteristics in different domains (cardiovascular, psychogical, sensory) are associated with dizziness. Some drugs might play a substantial role in these underlying conditions. Awareness of these characteristics can attribute to a goaldirected evaluation of elderly patients reporting dizziness. Further research is necessary to evaluate whether intervening in these characteristics is effective in reducing symptoms and disabilities associated with dizziness.
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