How Healthcare Utilization Due to Dizziness and Vertigo Differs Between Older and Younger Adults

Prell, Tino; Finn, Sigrid; Axer, Hubertus

doi:10.3389/fmed.2022.852187

Cited by 5 publications

(5 citation statements)

References 46 publications

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“…This could be demonstrated in the elastic net model after correction for cofactors and in the flexplot ( Figure 4 ). This effect occurred independent from the intensity of dizziness/vertigo, although it is known that dizziness-associated handicap increases with age ( 25 ) and older patients with dizziness have less anxiety than younger patients ( 26 ).…”

Section: Discussionmentioning

confidence: 86%

“…In an earlier study, we found that younger people were more frequently hospitalized due to dizziness than older adults, and the number of consultations of healthcare providers was considerably higher in younger patients ( 26 ). Now, we can hypothesize that a higher tolerance of dizziness increases the threshold to initiate specialized vertigo therapy and could partly explain lower healthcare utilization in older patients.…”

Section: Discussionmentioning

confidence: 92%

“…This means that people with depressive symptoms in general rate their current and tolerable dizziness higher in comparison to people with a lower HADS-D (while the gap between both remains stable). Given that older people with chronic dizziness report lower levels of depression and anxiety ( 26 ), we assume that the higher tolerance with increasing age occurs independently of these psychological cofactors. Our findings are in line with earlier studies, showing that depression is frequent and clinically relevant in people with dizziness and that depression influences the severity and outcome of dizziness ( 12 , 35 – 37 ).…”

Section: Discussionmentioning

confidence: 99%

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Tolerance to Dizziness Intensity Increases With Age in People With Chronic Dizziness

2022

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BackgroundDizziness is a common complaint in older adults. To know which factors are instrumental in enabling patients with chronic dizziness to tolerate their symptoms to a certain degree in everyday life can help to develop tailored therapies.MethodsData from 358 patients with chronic dizziness and vertigo who had attended a multimodal daycare treatment program were recorded. Data included sociodemographic parameters, dizziness-related characteristics, the Vertigo Symptom Scale (VSS), and the Hospital Anxiety and Depression Scale (HADS). Descriptive statistics, elastic net regression, and mediation analysis were used.ResultsA higher tolerance of dizziness was associated with higher age, higher intensity of dizziness, lower burden of dizziness, higher HADS depression, structural reason for dizziness (type), permanent dizziness, absence of attacks, and longer disease duration. In contrast, younger persons with attack-like dizziness reported to tolerate less dizziness. Age had a significant direct effect on tolerance (72% of the total effect) and a significant indirect effect via intensity on tolerance (28% of the total effect) in the mediation analysis.ConclusionIt can only be speculated that negative stereotypes about age-related complaints may play a role in this. Why older people tolerate more dizziness and to what extent this may contribute to lower healthcare utilization need to be investigated in further studies.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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Tolerance to Dizziness Intensity Increases With Age in People With Chronic Dizziness

2022

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“…1). These results seem plausible because of the increased vestibulocochlear dysfunction with age [59][60][61][62], including the frequent cases without the patient noticing the vestibular dysfunction occurred [63][64][65]. Contrary, two published studies by Inui et al [40,58] showed that participants < 60 years had significantly larger TFS and ELS/TFS volume ratios in the inner ear and significantly larger ELS/TFS volume ratios in the vestibulum in comparison to the participant group ≥ 60 years.…”

Section: Els Age-dependencymentioning

confidence: 99%

Endolymphatic space is age-dependent

et al. 2022

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Knowledge of the physiological endolymphatic space (ELS) is necessary to estimate endolymphatic hydrops (ELH) in patients with vestibulocochlear syndromes. Therefore, the current study investigated age-dependent changes in the ELS of participants with normal vestibulocochlear testing. Sixty-four ears of 32 participants with normal vestibulocochlear testing aged between 21 and 75 years (45.8 ± 17.2 years, 20 females, 30 right-handed, two left-handed) were examined by intravenous delayed gadolinium-enhanced magnetic resonance imaging of the inner ear (iMRI). Clinical diagnostics included neuro-otological assessment, video-oculography during caloric stimulation, and head-impulse test. iMRI data analysis provided semi-quantitative visual grading and automatic algorithmic quantitative segmentation of ELS volume (3D, mm3) using a deep learning-based segmentation of the inner ear’s total fluid space (TFS) and volumetric local thresholding, as described earlier. As a result, following a 4-point ordinal scale, a mild ELH (grade 1) was found in 21/64 (32.8%) ears uni- or bilaterally in either cochlear, vestibulum, or both. Age and ELS were found to be positively correlated for the inner ear (r(64) = 0.33, p < 0.01), and vestibulum (r(64) = 0.25, p < 0.05). For the cochlea, the values correlated positively without reaching significance (r(64) = 0.21). In conclusion, age-dependent increases of the ELS should be considered when evaluating potential ELH in single subjects and statistical group comparisons.

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“…Die Häufigkeit von Physiotherapieverordnungen bei Patient*innen mit S/G nimmt mit dem Alter der Patient*innen ab [18]. Sie schwankt zwischen 41,3 % bei jüngeren Patient*innen (Mittelwert (MW): 55,3 Jahre) [19] und 4,4 % bei über 65-Jährigen [20].…”

Section: Introductionunclassified

Verordnung und Inanspruchnahme von Physiotherapie bei Schwindel und/oder Gleichgewichtsstörungen

Borchers,

Horstmannshoff,

Katzenberger

et al. 2023

physioscience

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Zusammenfassung Hintergrund Schwindel und/oder Gleichgewichtsstörungen (S/G) sind komplexe Gesundheitsprobleme bei älteren Menschen und häufige Beratungsanlässe in der Hausarztpraxis. Physiotherapie kann einen positiven Einfluss auf das Gleichgewicht und Sturzrisiko bei Patient*innen mit S/G haben. In der S3-DEGAM-Leitlinie „Akuter Schwindel in der Hausarztpraxis“ werden Empfehlungen für Physiotherapie bei bestimmten Schwindeldiagnosen gegeben. Ob hausärztliche Physiotherapieverordnungen den Empfehlungen der Leitlinie entsprechen, ist nicht bekannt. Bisher liegen keine Daten vor, wie häufig diese Physiotherapieverordnungen tatsächlich durch Patient*innen in Anspruch genommen werden. Ziel Ermittlung von Anteil und Inanspruchnahme hausärztlich verordneter Physiotherapie bei älteren Patient*innen mit S/G innerhalb der Kohortenstudie MobilE-TRA und Untersuchung, ob diese den Empfehlungen der S3-DEGAM-Leitlinie entsprechen. Methode Die Sekundäranalyse beruht auf Daten der Kohortenstudie MobilE-TRA, in der Patient*innen ab 65 Jahren mit S/G in 17 Hausarztpraxen in Bayern und Sachsen befragt wurden. Die Datenerhebung fand von 09/2017–10/2019 statt. Die hausärztliche Verordnung und patientenseitige Inanspruchnahme von Physiotherapie wurden mittels validierten sowie selbstentwickelten Fragebögen erhoben. Die Daten wurden deskriptiv (Mittelwerte, Häufigkeiten) und Verteilungsunterschiede mittels exaktem Test nach Fisher analysiert. Ergebnisse Die Stichprobe umfasste 158 Patient*innen mit S/G. 16 % der Patient*innen hatten aufgrund von S/G Physiotherapie verordnet bekommen. Dabei entsprachen 14,2 % der Physiotherapieverordnungen den Empfehlungen der S3-DEGAM-Leitlinie. 32 % (Bayern 53,8 %; Sachsen 8,3 %) der Patient*innen hatten die Physiotherapie nicht in Anspruch genommen. Dabei lag ein signifikanter regionaler Verteilungsunterschied (p = 0,030; Phi = 0,487 [95 % KI = 0,129–0,846]) vor. Schlussfolgerung Mit 16 % ist die Häufigkeit hausärztlicher Physiotherapieverordnungen bei S/G in der Altersgruppe der über 65-Jährigen vergleichsweise hoch. Die Gründe für die Nichtinanspruchnahme wurden nicht erfasst, weshalb nur Vermutungen bezüglich des regionalen Unterschiedes angestellt werden konnten (z. B. Verfügbarkeit von Physiotherapie). Im Sinne der Planung einer adhärenten Therapie und zur Vermeidung von Versorgungsunterschieden scheint es sinnvoll, sich zukünftig auch mit Gründen einer Nichtinanspruchnahme von Therapien zu beschäftigen.

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How Healthcare Utilization Due to Dizziness and Vertigo Differs Between Older and Younger Adults

Cited by 5 publications

References 46 publications

Tolerance to Dizziness Intensity Increases With Age in People With Chronic Dizziness

Tolerance to Dizziness Intensity Increases With Age in People With Chronic Dizziness

Endolymphatic space is age-dependent

Verordnung und Inanspruchnahme von Physiotherapie bei Schwindel und/oder Gleichgewichtsstörungen

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