Dizziness among older adults: A possible geriatric syndrome

Background: In previous studies of dizziness, the prevalence of specific ca uses has varied widely and either no or multiple causes have been identifie d. Dizziness might be better considered a geriatric syndrome that results f rom impairment or disease in multiple systems. Objective: To determine the predisposing characteristics and situational fa ctors associated with dizziness. Design: Population-based, cross-sectional study. Setting: Community Participants: Probability sample of 1087 community-living persons in New Ha ven, Connecticut, who were at least 72 years of age. Measurements: Episodes of dizziness that occurred for at least 1 month; man ifestations of dizziness; and predisposing demographic, medical, neurologic , sensory, and psychological characteristics. Results: 261 participants (24%) reported dizziness; 56% of dizzy persons de scribed several sensations and 74% reported several triggering activities. The adjusted relative risks for characteristics associated with dizziness w ere 1.69 (95% CI, 1.24 to 2.30) for anxiety, 1.36 (CI, 1.02 to 1.80) for de pressive symptoms, 1.27 (CI, 0.99 to 1.63) for impaired hearing, 1.30 (CI, 1.01 to 1.68) for five or more medications, 1.31 (CI, 0.92 to 1.87) for pos tural hypotension, 1.34 (CI, 0.95 to 1.90) for impaired balance, and 1.31 ( CI, 1.00 to 1.71) for past myocardial infarction. The adjusted relative ris k for dizziness was 1.38 (CI, 1.27 to 1.49) for each additional characteris tic. Conclusions: The association among characteristics in multiple domains (car diovascular, neurologic, sensory, psychological, and medication-related) an d dizziness, coupled with the multiplicity of sensations and triggering act ivities, suggests that dizziness may be a geriatric syndrome, similar to de lirium and falling. If so, an impairment reduction strategy, proven effecti ve for other geriatric syndromes, may be effective in reducing the symptoms and disabilities associated with dizziness.