Burden of Dizziness and Vertigo in the Community

Neuhauser, Hannelore; Radtke, A.; Brevern, Michael von; Lezius, F.; Feldmann, Maria; Lempert, Thomas

doi:10.1001/archinte.168.19.2118

Cited by 424 publications

(399 citation statements)

References 32 publications

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“…As for the syndromic distribution by gender, there was again a significant difference between the two, and the peripheral vestibular syndrome in the female gender was the most frequent, given the concordance with those reported in several studies [5,18,23]. Age groups aged 40 to 59 years and equal to or above 60 years had similar results, although some studies indicate that the majority of individuals complaining of dizziness are the elderly [3,23,24].…”

Section: Discussionsupporting

confidence: 62%

“…These data do not differ from those found in the literature, which point out that the main causes of otoneurological symptoms are those that affect the peripheral vestibular system [17]. However, attacks of central origin are generally more dangerous and deserve attention [18].…”

Section: Discussionsupporting

confidence: 50%

“…Several studies have shown that women are more susceptible than men to otoneurological changes. This "sensitivity" could be attributed in part to the natural hormonal variations that the woman presents [18,21]. Studies suggest that female sex hormones would physically alter peripheral vestibular function because of changes in endolymphatic pressure and blood viscosity.…”

Section: Discussionmentioning

confidence: 99%

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Vestibular Test in a Population with Dizziness Complain

Maia¹,

Miterhof²,

Felipe³

2017

JOENTR

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Section: Discussionsupporting

confidence: 62%

Section: Discussionsupporting

confidence: 50%

Section: Discussionmentioning

confidence: 99%

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Vestibular Test in a Population with Dizziness Complain

Maia¹,

Miterhof²,

Felipe³

2017

JOENTR

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“…The study also showed that vertigo is recurrent in the vast majority of patients (88%). Vertigo has a considerable individual and social impact, causing interruption of daily activities in 40% of affected individuals, sick leave in 41% and avoidance of leaving the house in 19% according to a recent survey [ 44 ].…”

Section: Epidemiology Of Vertigomentioning

confidence: 99%

Epidemiology of vertigo, migraine and vestibular migraine

2009

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Both migraine and vertigo are common in the general population with lifetime prevalences of about 16% for migraine and 7% for vertigo. Therefore, a concurrence of the two conditions can be expected in about 1.1% percent of the general population by chance alone. However, recent epidemiological evidence suggests that the actual comorbidity is higher, namely 3.2 %. This can be explained by the fact that several dizziness and vertigo syndromes occur more frequently in migraineurs than in controls including benign paroxysmal positional vertigo, Meniere's disease, motion sickness, cerebellar disorders and anxiety syndromes which may present with dizziness. In addition, there is increasing recognition of a syndrome called vestibular migraine (VM), which is vertigo directly caused by migraine. VM affects more than 1% of the general population, about 10% of patients in dizziness clinics and at least 9% of patients in migraine clinics.Clinically, VM presents with attacks of spontaneous or positional vertigo lasting seconds to days. Migrainous accompaniments such as headache, phonophobia, photophobia or auras are common but not mandatory. Cochlear symptoms may be associated but are mostly mild and non-progressive. During acute attacks one may find central spontaneous or positional nystagmus and, less commonly, unilateral vestibular hypofunction. In the symptom-free interval, vestibular testing adds little to the diagnosis as findings are mostly minor and non-specific. In the absence of controlled studies, treatment of VM is adopted from the migraine sphere comprising avoidance of triggers, stress management as well as pharmacotherapy for acute attacks and prophylaxis.

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“…Loss of vestibular function can be a debilitating condition that causes imbalance, unsteady vision, and a 12‐fold increased risk of falls and fall‐associated morbidity 1. Individuals with vestibular loss have difficulty carrying out activities of daily living such as walking, climbing stairs, and driving, and these individuals report increased dependence on others, reduced productivity, and decreased life satisfaction 2, 3, 4, 5. As with other sensory systems, vestibular function declines with age, and older individuals are disproportionately affected by vestibular loss.…”

Section: Introductionmentioning

confidence: 99%

Health‐related quality of life and economic burden of vestibular loss in older adults

Agrawal

Pineault

Semenov

2017

Laryngoscope Investig Oto

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ObjectivesVestibular loss is a debilitating condition, and despite its high prevalence in older adults, the quality of life (QoL) burden of vestibular loss in older individuals has not been well‐studied. This report quantifies the impact on overall QoL and identifies domains of health most affected. We hypothesize vestibular loss will be associated with impairment in diverse domains of health‐related QoL.Study DesignProspective, case‐control study.MethodsA convenience sample of 27 patients age ≥60 years with vestibular physiologic loss was recruited from an academic neurotology clinic. The patients did not have any identifiable cause of their vestibular loss other than aging. The convenience sample was compared to an age‐matched cross‐sectional sample of the general US population (n = 1266). The main outcome was QoL measured by the Ontario Health Utilities Index Mark III (HUI3).ResultsCompared to the general population, patients with vestibular loss had significantly lower overall unadjusted HUI3 scores (−0.32, p < 0.001). Multivariate regression analysis showed vestibular loss was significantly associated with poorer performance in vision (−0.11 p < 0.0001), speech (−0.15, p < 0.0001), dexterity (−0.13, p < 0.0001), and emotion (−0.07, p = 0.0065). Adjusted aggregate HUI3 was also significantly lower for vestibular loss (−0.15, p = 0.0105). These QoL decrements resulted in an average loss of 1.30 Quality‐Adjusted Life Years (QALYs). When using a $50,000/QALY willingness‐to‐pay threshold, vestibular loss was associated with a $64,929 lifetime economic burden per affected older adult, resulting in a total lifetime societal burden of $227 billion for the US population ≥60 years of age.ConclusionsLoss of vestibular function with aging significantly decreases quality of life across multiple domains of well‐being. These QoL reductions are responsible for heavy societal economic burdens of vestibular loss, which reveal potential benefits of prompt diagnosis and treatment of this condition.Level of Evidence3

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Burden of Dizziness and Vertigo in the Community

Cited by 424 publications

References 32 publications

Vestibular Test in a Population with Dizziness Complain

Vestibular Test in a Population with Dizziness Complain

Epidemiology of vertigo, migraine and vestibular migraine

Health‐related quality of life and economic burden of vestibular loss in older adults

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