Health, functional, and psychological outcomes among older persons with chronic dizziness.
OBJECTIVE
The recommended clinical strategy for a health condition should depend both on the known causes of and outcomes associated with the condition. The aim of this study was to determine the range of adverse outcomes associated with chronic dizziness.


METHODS
Population-based prospective cohort study.


METHODS
A probability sample of 1087 persons, age 72 and older, living in the community.


METHODS
The following were measured: chronic dizziness, death, hospitalizations, falls, syncope, basic and instrumental activities of daily living, depressive symptoms, self-rated health, falls self-efficacy, and social activities.


RESULTS
Of the 1087 participants, 261 (24%) reported chronic dizziness. Over 1 year of follow-up, chronic dizziness was not associated with mortality, hospitalization for any reason, or change in basic or instrumental activities of daily living, but was associated with risk of falling (unadjusted relative risk [RR] 1.35; 95% confidence interval [CI] 1.06-1.72) and with experiencing syncope (RR 2.31; 95% CI 1.24-4.30). After adjustment for baseline level, chronic dizziness also was associated with worsening of depressive symptoms, self-rated health, falls efficacy, and social activities. The relationship remained significant, after adjustment for potential confounding factors, for self-rated health (T-statistic -2.95, P = .003) and falls efficacy (T-statistic -2.68; P = .008), and was of marginal significance for depressive symptoms (T-statistic -1.73; P = .085).


CONCLUSIONS
These results suggest that the goals of care for older persons with chronic dizziness should be redirected from solely identifying and treating discrete diseases--an often expensive and unrewarding task--toward reducing the symptoms of chronic dizziness and alleviating the resulting physical, psychological, and social disability.
Tinetti
M E
ME
Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.
Williams
C S
CS
Gill
T M
TM
D000058:Accidental Falls / Q000706:statistics & numerical data; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002908:Chronic Disease; D004244:Dizziness / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D015577:Geriatric Assessment; D006760:Hospitalization; D006801:Humans; D008297:Male; D011159:Population Surveillance; D015995:Prevalence; D011446:Prospective Studies