The social impact of dizziness in London and Siena

Abstract

Although dizziness is a common presenting symptom in general and hospital practice, its social cost is not known. We assessed the social and work life impact of dizziness on patients in two contrasting European cities, Siena and London. First, we developed the 'Social life & Work Impact of Dizziness questionnaire' (SWID), which was validated by administering it to 43 patients with dizziness and 45 normal controls and by correlating the results with the EQ-5D (Europe quality of life) questionnaire. The SWID and EQ-5D scores were worse in patients than controls (p < 0.001) and the two correlated significantly (r = 0.50 p < 0.001). Then two hundred consecutive patients per city attending tertiary specialised 'dizzy patient' clinics, one in London led by a neurologist, one in Siena led by an ear, nose and throat specialist (ENT), were investigated with SWID. Amongst the 400 patients, 27% reported changing their jobs and 21% giving up work as a result of the dizziness. Over 50% of patients felt that their efficiency at work had dropped considerably. The mean number of days off work attributed to the dizziness in the previous 6 months was 7.15 days. Social life was disrupted in 57% of all 400 patients. Factor analysis identified that detrimental effects on work, travel, social and family life combine to create a single factor accounting for much of the overall impact of their dizziness. Significant differences in some measures of handicap between London and Siena emerged, with London patients often faring worse. Reasons for these location differences include, as expected, a higher proportion of neurological patients in London than in Siena. However, factors related to city demographics and social cohesion may also modulate the impact on quality of life and working practice. Regardless of inter-city differences, these findings highlight the high social and economic impact of dizziness.

Recent advances in the diagnosis and treatment of balance disorders

“…The high social and economic impact of dizziness was recently illustrated by a study that interviewed 400 consecutive dizzy patients by questionnaire [5]. Over 50% of the patients felt that their efficiency at work had dropped, and over 20% had had to quit their work as a result of the dizziness.…”

Visual dependence and BPPV

“…In specialised neurology, ENT and neuro-otology clinics it is common to see patients with long standing symptoms of dizziness, the onset of which can be traced to acute symptoms of vertigo months to years previously [1,2]. Although there is no consensus on a diagnosis for these patients, explanations for the prolongation of symptoms range from psychological disorders [2][3][4] to defective central compensation of the initial peripheral vestibular insult [5,6].…”

Effectiveness of Vestibular Rehabilitation in Hemodialysis Patients With Dizziness

“…Dizziness adversely affects daily living activities, work ability, and balance, and increases the risk and fear of falls for the elderly (Bronstein et al, 2010;Dros et al, 2011;Maarsingh, Dros, Schellevis, van Weert, van der Windt et al, 2010;dos Santos, Gazzola, Gananca, Caovilla, & Gananca, 2010). This condition may be the consequence of the aging process and also of certain nonaging processes such as vestibular disorder, cardiac, and neurological diseases, psychological factors, and side effects of medications in the older population (Maarsingh, Dros, Schellevis, van Weert, Bindels et al, 2010;Maarsingh, Dros, Schellevis, van Weert, van der Windt et al, 2010).…”