Skip to main content
Top
Published in: BMC Primary Care 1/2010

Open Access 01-12-2010 | Research article

Dizziness reported by elderly patients in family practice: prevalence, incidence, and clinical characteristics

Authors: Otto R Maarsingh, Jacquelien Dros, François G Schellevis, Henk C van Weert, Patrick J Bindels, Henriette E van der Horst

Published in: BMC Primary Care | Issue 1/2010

Login to get access

Abstract

Background

Although dizziness in elderly patients is very common in family practice, most prevalence studies on dizziness are community-based and include a study population that is not representative of family practice. The aim of this study was to investigate the prevalence and incidence of dizziness reported by elderly patients in family practice, to describe their final diagnoses as recorded by the family physician, and to compare the clinical characteristics of dizzy patients with those of non-dizzy patients.

Methods

Data were obtained from the Second Dutch National Survey of General Practice, a prospective registration study which took place over a 12-month period in 2001. We developed a search strategy consisting of 15 truncated search terms (based on Dutch synonyms for dizziness), and identified all patients aged 65 or older who visited their family physician because of dizziness (N = 3,990). We used the mid-time population as denominator to calculate the prevalence and incidence, and for group comparisons we used the Student's t and Chi-square test, and logistic regression analysis.

Results

The one-year prevalence of dizziness in family practice in patients aged 65 or older was 8.3%, it was higher in women than in men, and it increased with age. In patients aged 85 or older the prevalence was similar for men and women. The incidence of dizziness was 47.1 per 1000 person-years. For 39% of the dizzy patients the family physicians did not specify a diagnosis, and recorded a symptom diagnosis as the final diagnosis. Living alone, lower level of education, pre-existing cerebrovascular disease, and pre-existing hypertension were independently associated with dizziness.

Conclusions

Dizziness in family practice patients increases with age. It is more common in women than in men, but this gender difference disappears in the very old. Because a large proportion of dizzy elderly patients in family practice remains undiagnosed, it would be worthwhile to carry out more diagnostic research on dizziness in a family practice setting.
Appendix
Available only for authorised users
Literature
1.
go back to reference Aggarwal NT, Bennett DA, Bienias JL, Mendes de Leon CF, Morris MC, Evans DA: The prevalence of dizziness and its association with functional disability in a biracial community population. J Gerontol A Biol Sci Med Sci. 2000, 55: M288-M292.CrossRefPubMed Aggarwal NT, Bennett DA, Bienias JL, Mendes de Leon CF, Morris MC, Evans DA: The prevalence of dizziness and its association with functional disability in a biracial community population. J Gerontol A Biol Sci Med Sci. 2000, 55: M288-M292.CrossRefPubMed
2.
go back to reference Colledge NR, Wilson JA, Macintyre CC, MacLennan WJ: The prevalence and characteristics of dizziness in an elderly community. Age Ageing. 1994, 23: 117-120. 10.1093/ageing/23.2.117.CrossRefPubMed Colledge NR, Wilson JA, Macintyre CC, MacLennan WJ: The prevalence and characteristics of dizziness in an elderly community. Age Ageing. 1994, 23: 117-120. 10.1093/ageing/23.2.117.CrossRefPubMed
3.
go back to reference Jonsson R, Sixt E, Landahl S, Rosenhall U: Prevalence of dizziness and vertigo in an urban elderly population. J Vestib Res. 2004, 14: 47-52.PubMed Jonsson R, Sixt E, Landahl S, Rosenhall U: Prevalence of dizziness and vertigo in an urban elderly population. J Vestib Res. 2004, 14: 47-52.PubMed
4.
go back to reference Sloane P, Blazer D, George LK: Dizziness in a community elderly population. J Am Geriatr Soc. 1989, 37: 101-108.CrossRefPubMed Sloane P, Blazer D, George LK: Dizziness in a community elderly population. J Am Geriatr Soc. 1989, 37: 101-108.CrossRefPubMed
5.
go back to reference Tilvis RS, Hakala SM, Valvanne J, Erkinjuntti T: Postural hypotension and dizziness in a general aged population: a four-year follow-up of the Helsinki Aging Study. J Am Geriatr Soc. 1996, 44: 809-814.CrossRefPubMed Tilvis RS, Hakala SM, Valvanne J, Erkinjuntti T: Postural hypotension and dizziness in a general aged population: a four-year follow-up of the Helsinki Aging Study. J Am Geriatr Soc. 1996, 44: 809-814.CrossRefPubMed
6.
go back to reference Tinetti ME, Williams CS, Gill TM: Dizziness among older adults: a possible geriatric syndrome. Ann Intern Med. 2000, 132: 337-344.CrossRefPubMed Tinetti ME, Williams CS, Gill TM: Dizziness among older adults: a possible geriatric syndrome. Ann Intern Med. 2000, 132: 337-344.CrossRefPubMed
7.
go back to reference Kroenke K, Lucas CA, Rosenberg ML, Scherokman BJ: Psychiatric disorders and functional impairment in patients with persistent dizziness. J Gen Intern Med. 1993, 8: 530-535. 10.1007/BF02599633.CrossRefPubMed Kroenke K, Lucas CA, Rosenberg ML, Scherokman BJ: Psychiatric disorders and functional impairment in patients with persistent dizziness. J Gen Intern Med. 1993, 8: 530-535. 10.1007/BF02599633.CrossRefPubMed
8.
go back to reference Nazareth I, Yardley L, Owen N, Luxon L: Outcome of symptoms of dizziness in a general practice community sample. Fam Pract. 1999, 16: 616-618. 10.1093/fampra/16.6.616.CrossRefPubMed Nazareth I, Yardley L, Owen N, Luxon L: Outcome of symptoms of dizziness in a general practice community sample. Fam Pract. 1999, 16: 616-618. 10.1093/fampra/16.6.616.CrossRefPubMed
9.
go back to reference Bailey KE, Sloane PD, Mitchell M, Preisser J: Which primary care patients with dizziness will develop persistent impairment?. Arch Fam Med. 1993, 2: 847-852. 10.1001/archfami.2.8.847.CrossRefPubMed Bailey KE, Sloane PD, Mitchell M, Preisser J: Which primary care patients with dizziness will develop persistent impairment?. Arch Fam Med. 1993, 2: 847-852. 10.1001/archfami.2.8.847.CrossRefPubMed
10.
go back to reference Hoffman RM, Einstadter D, Kroenke K: Evaluating dizziness. Am J Med. 1999, 107: 468-478. 10.1016/S0002-9343(99)00260-0.CrossRefPubMed Hoffman RM, Einstadter D, Kroenke K: Evaluating dizziness. Am J Med. 1999, 107: 468-478. 10.1016/S0002-9343(99)00260-0.CrossRefPubMed
11.
go back to reference Sloane PD, Coeytaux RR, Beck RS, Dallara J: Dizziness: state of the science. Ann Intern Med. 2001, 134: 823-832.CrossRefPubMed Sloane PD, Coeytaux RR, Beck RS, Dallara J: Dizziness: state of the science. Ann Intern Med. 2001, 134: 823-832.CrossRefPubMed
12.
go back to reference Okkes IM, Oskam SK, Lamberts H: From complaint to diagnosis. Episode data from family practice. 1998, Bussum, The Netherlands: Coutinho Okkes IM, Oskam SK, Lamberts H: From complaint to diagnosis. Episode data from family practice. 1998, Bussum, The Netherlands: Coutinho
13.
go back to reference Sloane PD: Dizziness in primary care. Results from the National Ambulatory Medical Care Survey. J Fam Pract. 1989, 29: 33-38.PubMed Sloane PD: Dizziness in primary care. Results from the National Ambulatory Medical Care Survey. J Fam Pract. 1989, 29: 33-38.PubMed
14.
go back to reference Boult C, Murphy J, Sloane P, Mor V, Drone C: The relation of dizziness to functional decline. J Am Geriatr Soc. 1991, 39: 858-861.CrossRefPubMed Boult C, Murphy J, Sloane P, Mor V, Drone C: The relation of dizziness to functional decline. J Am Geriatr Soc. 1991, 39: 858-861.CrossRefPubMed
15.
go back to reference Kroenke K, Price RK: Symptoms in the community. Prevalence, classification, and psychiatric comorbidity. Arch Intern Med. 1993, 153: 2474-2480. 10.1001/archinte.153.21.2474.CrossRefPubMed Kroenke K, Price RK: Symptoms in the community. Prevalence, classification, and psychiatric comorbidity. Arch Intern Med. 1993, 153: 2474-2480. 10.1001/archinte.153.21.2474.CrossRefPubMed
16.
go back to reference Neuhauser HK, Radtke A, von Brevern M, Lezius F, Feldmann M, Lempert T: Burden of dizziness and vertigo in the community. Arch Intern Med. 2008, 168: 2118-2124. 10.1001/archinte.168.19.2118.CrossRefPubMed Neuhauser HK, Radtke A, von Brevern M, Lezius F, Feldmann M, Lempert T: Burden of dizziness and vertigo in the community. Arch Intern Med. 2008, 168: 2118-2124. 10.1001/archinte.168.19.2118.CrossRefPubMed
17.
go back to reference Agrawal Y, Carey JP, la Santina CC, Schubert MC, Minor LB: Disorders of balance and vestibular function in US adults: data from the National Health and Nutrition Examination Survey, 2001-2004. Arch Intern Med. 2009, 169: 938-944. 10.1001/archinternmed.2009.66.CrossRefPubMed Agrawal Y, Carey JP, la Santina CC, Schubert MC, Minor LB: Disorders of balance and vestibular function in US adults: data from the National Health and Nutrition Examination Survey, 2001-2004. Arch Intern Med. 2009, 169: 938-944. 10.1001/archinternmed.2009.66.CrossRefPubMed
18.
go back to reference Wiltink J, Tschan R, Michal M, Subic-Wrana C, Eckhardt-Henn A, Dieterich M, et al: Dizziness: anxiety, health care utilization and health behavior--results from a representative German community survey. J Psychosom Res. 2009, 66: 417-424. 10.1016/j.jpsychores.2008.09.012.CrossRefPubMed Wiltink J, Tschan R, Michal M, Subic-Wrana C, Eckhardt-Henn A, Dieterich M, et al: Dizziness: anxiety, health care utilization and health behavior--results from a representative German community survey. J Psychosom Res. 2009, 66: 417-424. 10.1016/j.jpsychores.2008.09.012.CrossRefPubMed
19.
go back to reference Yardley L, Owen N, Nazareth I, Luxon L: Prevalence and presentation of dizziness in a general practice community sample of working age people. Br J Gen Pract. 1998, 48: 1131-1135.PubMedPubMedCentral Yardley L, Owen N, Nazareth I, Luxon L: Prevalence and presentation of dizziness in a general practice community sample of working age people. Br J Gen Pract. 1998, 48: 1131-1135.PubMedPubMedCentral
20.
go back to reference Westert GP, Schellevis FG, De Bakker DH, Groenewegen PP, Bensing JM, van der ZJ: Monitoring health inequalities through general practice: the Second Dutch National Survey of General Practice. Eur J Public Health. 2005, 15: 59-65. 10.1093/eurpub/cki116.CrossRefPubMed Westert GP, Schellevis FG, De Bakker DH, Groenewegen PP, Bensing JM, van der ZJ: Monitoring health inequalities through general practice: the Second Dutch National Survey of General Practice. Eur J Public Health. 2005, 15: 59-65. 10.1093/eurpub/cki116.CrossRefPubMed
21.
go back to reference Veehof L, Stewart R, Haaijer-Ruskamp F, Jong BM: The development of polypharmacy. A longitudinal study. Fam Pract. 2000, 17: 261-267. 10.1093/fampra/17.3.261.CrossRefPubMed Veehof L, Stewart R, Haaijer-Ruskamp F, Jong BM: The development of polypharmacy. A longitudinal study. Fam Pract. 2000, 17: 261-267. 10.1093/fampra/17.3.261.CrossRefPubMed
22.
go back to reference Kao AC, Nanda A, Williams CS, Tinetti ME: Validation of dizziness as a possible geriatric syndrome. J Am Geriatr Soc. 2001, 49: 72-75. 10.1046/j.1532-5415.2001.49012.x.CrossRefPubMed Kao AC, Nanda A, Williams CS, Tinetti ME: Validation of dizziness as a possible geriatric syndrome. J Am Geriatr Soc. 2001, 49: 72-75. 10.1046/j.1532-5415.2001.49012.x.CrossRefPubMed
23.
go back to reference Lamberts H, Wood M, eds: ICPC. International Classification of Primary Care. 1987, Oxford: Oxford University Press Lamberts H, Wood M, eds: ICPC. International Classification of Primary Care. 1987, Oxford: Oxford University Press
24.
go back to reference Lamberts H, Hofmans-Okkes I: The core of computer based patient records in family practice: episodes of care classified with ICPC. Int J Biomed Comput. 1996, 42: 35-41. 10.1016/0020-7101(96)01179-8.CrossRefPubMed Lamberts H, Hofmans-Okkes I: The core of computer based patient records in family practice: episodes of care classified with ICPC. Int J Biomed Comput. 1996, 42: 35-41. 10.1016/0020-7101(96)01179-8.CrossRefPubMed
26.
go back to reference Kruschinski C, Kersting M, Breull A, Kochen MM, Koschack J, Hummers-Pradier E: [Frequency of dizziness-related diagnoses and prescriptions in a general practice database]. Z Evid Fortbild Qual Gesundhwes. 2008, 102: 313-319. 10.1016/j.zefq.2008.05.001.CrossRefPubMed Kruschinski C, Kersting M, Breull A, Kochen MM, Koschack J, Hummers-Pradier E: [Frequency of dizziness-related diagnoses and prescriptions in a general practice database]. Z Evid Fortbild Qual Gesundhwes. 2008, 102: 313-319. 10.1016/j.zefq.2008.05.001.CrossRefPubMed
27.
go back to reference Stevens KN, Lang IA, Guralnik JM, Melzer D: Epidemiology of balance and dizziness in a national population: findings from the English Longitudinal Study of Ageing. Age Ageing. 2008, 37: 300-305. 10.1093/ageing/afn019.CrossRefPubMed Stevens KN, Lang IA, Guralnik JM, Melzer D: Epidemiology of balance and dizziness in a national population: findings from the English Longitudinal Study of Ageing. Age Ageing. 2008, 37: 300-305. 10.1093/ageing/afn019.CrossRefPubMed
28.
go back to reference Hanley K, O' Dowd T: Symptoms of vertigo in general practice: a prospective study of diagnosis. Br J Gen Pract. 2002, 52: 809-812.PubMedPubMedCentral Hanley K, O' Dowd T: Symptoms of vertigo in general practice: a prospective study of diagnosis. Br J Gen Pract. 2002, 52: 809-812.PubMedPubMedCentral
29.
go back to reference Sloane PD, Dallara J, Roach C, Bailey KE, Mitchell M, McNutt R: Management of dizziness in primary care. J Am Board Fam Pract. 1994, 7: 1-8.PubMed Sloane PD, Dallara J, Roach C, Bailey KE, Mitchell M, McNutt R: Management of dizziness in primary care. J Am Board Fam Pract. 1994, 7: 1-8.PubMed
30.
go back to reference Kroenke K, Lucas CA, Rosenberg ML, Scherokman B, Herbers JE, Wehrle PA, et al: Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care. Ann Intern Med. 1992, 117: 898-904.CrossRefPubMed Kroenke K, Lucas CA, Rosenberg ML, Scherokman B, Herbers JE, Wehrle PA, et al: Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care. Ann Intern Med. 1992, 117: 898-904.CrossRefPubMed
31.
go back to reference Lawson J, Fitzgerald J, Birchall J, Aldren CP, Kenny RA: Diagnosis of geriatric patients with severe dizziness. J Am Geriatr Soc. 1999, 47: 12-17.CrossRefPubMed Lawson J, Fitzgerald J, Birchall J, Aldren CP, Kenny RA: Diagnosis of geriatric patients with severe dizziness. J Am Geriatr Soc. 1999, 47: 12-17.CrossRefPubMed
32.
go back to reference Madlon-Kay DJ: Evaluation and outcome of the dizzy patient. J Fam Pract. 1985, 21: 109-113.PubMed Madlon-Kay DJ: Evaluation and outcome of the dizzy patient. J Fam Pract. 1985, 21: 109-113.PubMed
33.
go back to reference Neuhauser HK, von Brevern M, Radtke A, Lezius F, Feldmann M, Ziese T, et al: Epidemiology of vestibular vertigo: a neurotologic survey of the general population. Neurology. 2005, 65: 898-904. 10.1212/01.wnl.0000175987.59991.3d.CrossRefPubMed Neuhauser HK, von Brevern M, Radtke A, Lezius F, Feldmann M, Ziese T, et al: Epidemiology of vestibular vertigo: a neurotologic survey of the general population. Neurology. 2005, 65: 898-904. 10.1212/01.wnl.0000175987.59991.3d.CrossRefPubMed
34.
go back to reference Regidor E, Calle ME, Navarro P, Dominguez V: The size of educational differences in mortality from specific causes of death in men and women. Eur J Epidemiol. 2003, 18: 395-400. 10.1023/A:1024296932294.CrossRefPubMed Regidor E, Calle ME, Navarro P, Dominguez V: The size of educational differences in mortality from specific causes of death in men and women. Eur J Epidemiol. 2003, 18: 395-400. 10.1023/A:1024296932294.CrossRefPubMed
Metadata
Title
Dizziness reported by elderly patients in family practice: prevalence, incidence, and clinical characteristics
Authors
Otto R Maarsingh
Jacquelien Dros
François G Schellevis
Henk C van Weert
Patrick J Bindels
Henriette E van der Horst
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2010
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/1471-2296-11-2

Other articles of this Issue 1/2010

BMC Primary Care 1/2010 Go to the issue