Predictors of dizziness in older persons: a 10-year prospective cohort study in the community

BMC Geriatrics

Johannes C van der Wouden¹  Matthew J Ridd⁴  Natasja M van Schoor³  Peter M van de Ven³  Hanneke Stam¹  Otto R Maarsingh² 

[1] Department of General Practice & Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands;Cohort 6, International Primary Care Research Leadership Programme, University of Oxford, Oxford, UK;Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, De Boelelaan 1118, 1081 HV Amsterdam, The Netherlands;Centre for Academic Primary Care, University of Bristol, Bristol, UK

关键词: Prospective cohort study;    Predictors;    Dizziness;    Older individuals;   

Others  :  1089804
DOI  :  10.1186/1471-2318-14-133

 received in 2014-09-02, accepted in 2014-12-11,  发布年份 2014

【 摘 要 】

Background

The current diagnosis-oriented approach of dizziness does not suit older patients. Often, it is difficult to identify a single underlying cause, and when a diagnosis is made, therapeutic options may be limited. Identification of predictors of dizziness may provide new leads for the management of dizziness in older patients. The aim of the present study was to investigate long-term predictors of regular dizziness in older persons.

Methods

Population-based cohort study of 1,379 community-dwelling participants, aged ≥60 years, from the Longitudinal Aging Study Amsterdam (LASA). Regular dizziness was ascertained during face-to-face medical interviews during 7- and 10-year follow-up. We investigated 26 predictors at baseline from six domains: socio-demographic, medical history, medication, psychological, sensory, and balance/gait. We performed multivariate logistic regression analyses with presence of regular dizziness at 7- and 10-year follow-up as dependent variables. We assessed the performance of the models by calculating calibration and discrimination.

Results

Predictors of regular dizziness at 7-year follow-up were living alone, history of dizziness, history of osteo/rheumatoid arthritis, use of nitrates, presence of anxiety or depression, impaired vision, and impaired function of lower extremities. Predictors of regular dizziness at 10-year follow-up were history of dizziness and impaired function of lower extremities. Both models showed good calibration (Hosmer-Lemeshow P value of 0.36 and 0.31, respectively) and acceptable discrimination (adjusted AUC after bootstrapping of 0.77 and 0.71).

Conclusions

Dizziness in older age was predicted by multiple factors. A multifactorial approach, targeting potentially modifiable predictors (e.g., physical exercise for impaired function of lower extremities), may add to the current diagnosis-oriented approach.

【 授权许可】

   
2014 Maarsingh et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

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