TY - JOUR
T1 - Functional Prognosis of Dizziness in Older Adults in Primary Care: A Prospective Cohort Study
AU - Dros, Jacquelien
AU - Maarsingh, Otto R.
AU - Beem, Leo
AU - van der Horst, Henriëtte E.
AU - ter Riet, Gerben
AU - Schellevis, François G.
AU - van Weert, Henk C. P. M.
PY - 2012
Y1 - 2012
N2 - Objectives To investigate the 6-month functional prognosis of dizziness in older adults in primary care, to identify important predictors of dizziness-related impairment, and to construct a score to assist risk prediction. Design Prospective cohort study with 6-month follow-up. Setting Twenty-four primary care practices in the Netherlands. Participants Four hundred seventeen older adults (mean age 78.5, range 6595, 74% female) presenting consecutively to primary care with dizziness. Measurements Tests, including history and physical and additional examination, previously selected by an international expert panel and based on an earlier systematic review, were performed. The main outcome measure was 6-month dizziness-related impairment score measured using the Dizziness Handicap Inventory. Results Follow-up was complete for 92% of participants. Although 61% of participants experienced less impairment at 6 months, 130 participants (34%) showed persistent dizziness-related impairment. Factors most predictive of dizziness-related impairment at 6 months were onset of dizziness at least 6 months before inclusion, standing still as a dizziness-provoking circumstance, trouble with walking or (almost) falling (associated symptom), polypharmacy, absence of diabetes mellitus, presence of anxiety or depressive disorder, and impaired functional mobility. A score was constructed using these predictors to estimate the functional prognosis of dizziness at 6 months. Conclusion A score based on the presence of easily obtainable clinical information facilitates identification of older adults in primary care with poor functional prognosis of their dizziness without exactly knowing the cause(s) of their dizziness. Clinical management might be most effective by treating factors that can be influenced, such as polypharmacy, anxiety and depression, and functional mobility. J Am Geriatr Soc 60:2263-2269, 2012
AB - Objectives To investigate the 6-month functional prognosis of dizziness in older adults in primary care, to identify important predictors of dizziness-related impairment, and to construct a score to assist risk prediction. Design Prospective cohort study with 6-month follow-up. Setting Twenty-four primary care practices in the Netherlands. Participants Four hundred seventeen older adults (mean age 78.5, range 6595, 74% female) presenting consecutively to primary care with dizziness. Measurements Tests, including history and physical and additional examination, previously selected by an international expert panel and based on an earlier systematic review, were performed. The main outcome measure was 6-month dizziness-related impairment score measured using the Dizziness Handicap Inventory. Results Follow-up was complete for 92% of participants. Although 61% of participants experienced less impairment at 6 months, 130 participants (34%) showed persistent dizziness-related impairment. Factors most predictive of dizziness-related impairment at 6 months were onset of dizziness at least 6 months before inclusion, standing still as a dizziness-provoking circumstance, trouble with walking or (almost) falling (associated symptom), polypharmacy, absence of diabetes mellitus, presence of anxiety or depressive disorder, and impaired functional mobility. A score was constructed using these predictors to estimate the functional prognosis of dizziness at 6 months. Conclusion A score based on the presence of easily obtainable clinical information facilitates identification of older adults in primary care with poor functional prognosis of their dizziness without exactly knowing the cause(s) of their dizziness. Clinical management might be most effective by treating factors that can be influenced, such as polypharmacy, anxiety and depression, and functional mobility. J Am Geriatr Soc 60:2263-2269, 2012
U2 - https://doi.org/10.1111/jgs.12031
DO - https://doi.org/10.1111/jgs.12031
M3 - Article
C2 - 23231549
SN - 0002-8614
VL - 60
SP - 2263
EP - 2269
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
IS - 12
ER -