Dizziness: State of the science

Dizziness is prevalent in all adult populations, causing considerable morbi dity and utilization of health services. In the community, the prevalence o f dizziness ranges from 1.8% in young adults to more than 30% in the elderl y. In the primary care setting, dizziness increases in frequency as a prese nting complaint; as many as 7% of elderly patients present with this sympto m. Classification of dizziness by subtype (vertigo, presyncope, disequilibr ium, and other) assists in the differential diagnosis. Various disease entities may cause dizziness, and the reported frequency of specific diagnoses varies widely, depending on setting, patient age, and i nvestigator bias. Life-threatening illnesses are rare in patients with dizz iness, but many have serious functional impairment. Dizziness can be diffic ult to diagnose, particularly in elderly persons, in whom it often represen ts dysfunction in more than one body system. Given the relatively underdeveloped state of the empirical literature on di zziness, investigators would benefit from use of consistent criteria to des cribe dizziness symptoms and establish diagnoses. Investigation of the effe cts of testing and treatment should focus on diagnoses that are life threat ening or lead to significant morbidity. In the elderly, a function-oriented approach should be studied and compared with current diagnosis-focused str ategies. Alternative therapies for chronic and recurrent dizziness also mer it investigation.