Skip to main content
Top
Published in: BMC Geriatrics 1/2017

Open Access 01-12-2017 | Study protocol

Tailored multifactorial intervention to improve dizziness symptoms and quality of life, balance and gait in dizziness sufferers aged over 50 years: protocol for a randomised controlled trial

Authors: Jasmine C. Menant, Americo A. Migliaccio, Cameron Hicks, Joanne Lo, Daniela Meinrath, Mayna Ratanapongleka, Jessica Turner, Daina L. Sturnieks, Kim Delbaere, Nickolai Titov, Catherine McVeigh, Jacqueline C. T. Close, Stephen R. Lord

Published in: BMC Geriatrics | Issue 1/2017

Login to get access

Abstract

Background

Dizziness is a frequently reported symptom in older people that can markedly impair quality of life. This manuscript presents the protocol for a randomised controlled trial, which has the main objective of determining the impact of comprehensive assessment followed by a tailored multifaceted intervention in reducing dizziness episodes and symptoms, improving associated impairments to balance and gait and enhancing quality of life in older people with self-reported significant dizziness.

Methods

Three hundred people aged 50 years or older, reporting significant dizziness in the past year will be recruited to participate in the trial. Participants allocated to the intervention group will receive a tailored, multifaceted intervention aimed at treating their dizziness symptoms over a 6 month trial period. Control participants will receive usual care. The primary outcome measures will be the frequency and duration of dizziness episodes, dizziness symptoms assessed with the Dizziness Handicap Inventory, choice-stepping reaction time and step time variability. Secondary outcomes will include health-related quality of life measures, depression and anxiety symptoms, concern about falling, balance and risk of falls assessed with the physiological fall risk assessment. Analyses will be by intention-to-treat.

Discussion

The study will determine the effectiveness of comprehensive assessment, combined with a tailored, multifaceted intervention on dizziness episodes and symptoms, balance and gait control and quality of life in older people experiencing dizziness. Clinical implications will be evident for the older population for the diagnosis and treatment of dizziness.

Trial registration

The study is registered with the Australia New Zealand Clinical Trials Registry ACTRN12612000379​819.
Literature
1.
go back to reference Aggarwal NT, Bennett DA, Bienias JL, de Leon Mendes 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:M288–92.CrossRefPubMed Aggarwal NT, Bennett DA, Bienias JL, de Leon Mendes 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:M288–92.CrossRefPubMed
2.
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;37:300–5.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;37:300–5.CrossRefPubMed
3.
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;23:117–20.CrossRefPubMed Colledge NR, Wilson JA, Macintyre CC, MacLennan WJ. The prevalence and characteristics of dizziness in an elderly community. Age Ageing. 1994;23:117–20.CrossRefPubMed
4.
go back to reference Tinetti ME, Williams CS, Gill TM. Health, functional, and psychological outcomes among older persons with chronic dizziness. J Am Geriatr Soc. 2000;48:417–21.CrossRefPubMed Tinetti ME, Williams CS, Gill TM. Health, functional, and psychological outcomes among older persons with chronic dizziness. J Am Geriatr Soc. 2000;48:417–21.CrossRefPubMed
5.
go back to reference Maarsingh OR, Dros J, Schellevis FG, van Weert HC, Bindels PJ, Horst HE. Dizziness reported by elderly patients in family practice: prevalence, incidence, and clinical characteristics. BMC Fam Pract. 2010;11:2.CrossRefPubMedPubMedCentral Maarsingh OR, Dros J, Schellevis FG, van Weert HC, Bindels PJ, Horst HE. Dizziness reported by elderly patients in family practice: prevalence, incidence, and clinical characteristics. BMC Fam Pract. 2010;11:2.CrossRefPubMedPubMedCentral
6.
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.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.CrossRefPubMed
7.
go back to reference Delbaere K, Close JCT, Heim J, Sachdev PS, Brodaty H, Slavin MJ, et al. A multifactorial approach for understanding fall risk in older people - a decision tree model. J Am Geriatr Soc. 2010;58:1679–85.CrossRefPubMed Delbaere K, Close JCT, Heim J, Sachdev PS, Brodaty H, Slavin MJ, et al. A multifactorial approach for understanding fall risk in older people - a decision tree model. J Am Geriatr Soc. 2010;58:1679–85.CrossRefPubMed
8.
go back to reference Halmagyi GM, Baloh R. Overview of common syndromes of vestibular disease. In: Baloh R, Halmagyi GM, editors. Disorders of the vestibular system. New York: Oxford University Press; 1996. p. 291–9. Halmagyi GM, Baloh R. Overview of common syndromes of vestibular disease. In: Baloh R, Halmagyi GM, editors. Disorders of the vestibular system. New York: Oxford University Press; 1996. p. 291–9.
11.
go back to reference Sloane PD, Coeytaux RR, Beck RS, Dallara J. Dizziness: state of the science. Ann Intern Med. 2001;134:823–32.CrossRefPubMed Sloane PD, Coeytaux RR, Beck RS, Dallara J. Dizziness: state of the science. Ann Intern Med. 2001;134:823–32.CrossRefPubMed
12.
go back to reference Tinetti ME, Williams CS, Gill TM. Dizziness among older adults: a possible geriatric syndrome. Ann Intern Med. 2000;132:337–44.CrossRefPubMed Tinetti ME, Williams CS, Gill TM. Dizziness among older adults: a possible geriatric syndrome. Ann Intern Med. 2000;132:337–44.CrossRefPubMed
13.
go back to reference Kroenke K, Lucas CA, Rosenberg ML, Scherokman B, Herbers Jr 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 Jr 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
14.
go back to reference Maarsingh OR, Dros J, Schellevis FG, van Weert HC, van der Windt DA, ter Riet G, et al. Causes of persistent dizziness in elderly patients in primary care. Ann Fam Med. 2010;8:196–205.CrossRefPubMedPubMedCentral Maarsingh OR, Dros J, Schellevis FG, van Weert HC, van der Windt DA, ter Riet G, et al. Causes of persistent dizziness in elderly patients in primary care. Ann Fam Med. 2010;8:196–205.CrossRefPubMedPubMedCentral
15.
go back to reference Newman-Toker DE, Cannon LM, Stofferahn ME, Rothman RE, Hsieh YH, Zee DS. Imprecision in patient reports of dizziness symptom quality: a cross-sectional study conducted in an acute care setting. Mayo Clin Proc. 2007;82:1329–40.CrossRefPubMed Newman-Toker DE, Cannon LM, Stofferahn ME, Rothman RE, Hsieh YH, Zee DS. Imprecision in patient reports of dizziness symptom quality: a cross-sectional study conducted in an acute care setting. Mayo Clin Proc. 2007;82:1329–40.CrossRefPubMed
16.
17.
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;47:12–7.CrossRefPubMed Lawson J, Fitzgerald J, Birchall J, Aldren CP, Kenny RA. Diagnosis of geriatric patients with severe dizziness. J Am Geriatr Soc. 1999;47:12–7.CrossRefPubMed
18.
go back to reference Stanton VA, Hsieh YH, Camargo Jr CA, Edlow JA, Lovett PB, Goldstein JN, et al. Overreliance on symptom quality in diagnosing dizziness: results of a multicenter survey of emergency physicians. Mayo Clin Proc. 2007;82:1319–28.CrossRefPubMed Stanton VA, Hsieh YH, Camargo Jr CA, Edlow JA, Lovett PB, Goldstein JN, et al. Overreliance on symptom quality in diagnosing dizziness: results of a multicenter survey of emergency physicians. Mayo Clin Proc. 2007;82:1319–28.CrossRefPubMed
19.
go back to reference Sloane PD, Dallara J. Clinical research and geriatric dizziness: the blind men and the elephant. J Am Geriatr Soc. 1999;47:113–4.CrossRefPubMed Sloane PD, Dallara J. Clinical research and geriatric dizziness: the blind men and the elephant. J Am Geriatr Soc. 1999;47:113–4.CrossRefPubMed
20.
go back to reference Dros J, Maarsingh OR, van der Horst H, Bindels PJ, Ter Riet G, van Weert HC. Tests used to evaluate dizziness in primary care. CMAJ. 2010;182:E621–31.CrossRefPubMedPubMedCentral Dros J, Maarsingh OR, van der Horst H, Bindels PJ, Ter Riet G, van Weert HC. Tests used to evaluate dizziness in primary care. CMAJ. 2010;182:E621–31.CrossRefPubMedPubMedCentral
21.
22.
go back to reference McDonnell MN, Hillier SL. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database Syst Rev. 2015;1:CD005397. McDonnell MN, Hillier SL. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database Syst Rev. 2015;1:CD005397.
23.
go back to reference Brignole M, Alboni P, Benditt DG, Bergfeldt L, Blanc JJ, Bloch Thomsen PE, et al. Guidelines on management (diagnosis and treatment) of syncope--update 2004. Europace. 2004;6:467–537.CrossRefPubMed Brignole M, Alboni P, Benditt DG, Bergfeldt L, Blanc JJ, Bloch Thomsen PE, et al. Guidelines on management (diagnosis and treatment) of syncope--update 2004. Europace. 2004;6:467–537.CrossRefPubMed
24.
go back to reference Campbell AJ, Robertson MC, Gardner MM, Norton RN, Tilyard MW, Buchner DM. Randomised controlled trial of a general practice programme of home based exercise to prevent falls in elderly women. BMJ. 1997;315:1065–9.CrossRefPubMedPubMedCentral Campbell AJ, Robertson MC, Gardner MM, Norton RN, Tilyard MW, Buchner DM. Randomised controlled trial of a general practice programme of home based exercise to prevent falls in elderly women. BMJ. 1997;315:1065–9.CrossRefPubMedPubMedCentral
25.
go back to reference Howe TE, Rochester L, Neil F, Skelton DA, Ballinger C. Exercise for improving balance in older people. Cochrane Database Syst Rev. 2011;11:CD004963. Howe TE, Rochester L, Neil F, Skelton DA, Ballinger C. Exercise for improving balance in older people. Cochrane Database Syst Rev. 2011;11:CD004963.
26.
go back to reference Butler AC, Chapman JE, Forman EM, Beck AT. The empirical status of cognitive-behavioral therapy: a review of meta-analyses. Clin Psychol Rev. 2006;26:17–31.CrossRefPubMed Butler AC, Chapman JE, Forman EM, Beck AT. The empirical status of cognitive-behavioral therapy: a review of meta-analyses. Clin Psychol Rev. 2006;26:17–31.CrossRefPubMed
27.
go back to reference Colledge NR, Barr-Hamilton RM, Lewis SJ, Sellar RJ, Wilson JA. Evaluation of investigations to diagnose the cause of dizziness in elderly people: a community based controlled study. BMJ. 1996;313:788–92.CrossRefPubMedPubMedCentral Colledge NR, Barr-Hamilton RM, Lewis SJ, Sellar RJ, Wilson JA. Evaluation of investigations to diagnose the cause of dizziness in elderly people: a community based controlled study. BMJ. 1996;313:788–92.CrossRefPubMedPubMedCentral
28.
go back to reference Maarsingh OR, Dros J, van Weert HC, Schellevis FG, Bindels PJ, van der Horst HE. Development of a diagnostic protocol for dizziness in elderly patients in general practice: a Delphi procedure. BMC Fam Pract. 2009;10:12.CrossRefPubMedPubMedCentral Maarsingh OR, Dros J, van Weert HC, Schellevis FG, Bindels PJ, van der Horst HE. Development of a diagnostic protocol for dizziness in elderly patients in general practice: a Delphi procedure. BMC Fam Pract. 2009;10:12.CrossRefPubMedPubMedCentral
29.
go back to reference Kruschinski C, Theile G, Dreier SD, Hummers-Pradier E. The priorities of elderly patients suffering from dizziness: a qualitative study. Eur J Gen Pract. 2010;16:6–11.CrossRefPubMed Kruschinski C, Theile G, Dreier SD, Hummers-Pradier E. The priorities of elderly patients suffering from dizziness: a qualitative study. Eur J Gen Pract. 2010;16:6–11.CrossRefPubMed
30.
go back to reference Brodaty H, Pond D, Kemp NM, Luscombe G, Harding L, Berman K, Huppert FA. The GPCOG: a new screening test for dementia designed for general practice. J Am Geriatr Soc. 2002;50:530–4.CrossRefPubMed Brodaty H, Pond D, Kemp NM, Luscombe G, Harding L, Berman K, Huppert FA. The GPCOG: a new screening test for dementia designed for general practice. J Am Geriatr Soc. 2002;50:530–4.CrossRefPubMed
31.
go back to reference Lord SR, Fitzpatrick RC. Choice stepping reaction time: a composite measure of falls risk in older people. J Gerontol A Biol Sci Med Sci. 2001;56:M627–32.CrossRefPubMed Lord SR, Fitzpatrick RC. Choice stepping reaction time: a composite measure of falls risk in older people. J Gerontol A Biol Sci Med Sci. 2001;56:M627–32.CrossRefPubMed
32.
go back to reference Callisaya ML, Blizzard L, Schmidt MD, McGinley JL, Srikanth VK. Ageing and gait variability--a population-based study of older people. Age Ageing. 2010;39:191–7.CrossRefPubMed Callisaya ML, Blizzard L, Schmidt MD, McGinley JL, Srikanth VK. Ageing and gait variability--a population-based study of older people. Age Ageing. 2010;39:191–7.CrossRefPubMed
33.
go back to reference Hansson EE, Mansson NO, Ringsberg KA, Hakansson A. Falls among dizzy patients in primary healthcare: an intervention study with control group. Int J Rehabil Res. 2008;31:51–7.CrossRefPubMed Hansson EE, Mansson NO, Ringsberg KA, Hakansson A. Falls among dizzy patients in primary healthcare: an intervention study with control group. Int J Rehabil Res. 2008;31:51–7.CrossRefPubMed
34.
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;168:2118–24.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;168:2118–24.CrossRefPubMed
35.
go back to reference Neuhauser HK, Radtke A, von Brevern M, Feldmann M, Lezius F, Ziese T, et al. Migrainous vertigo: prevalence and impact on quality of life. Neurology. 2006;67:1028–33.CrossRefPubMed Neuhauser HK, Radtke A, von Brevern M, Feldmann M, Lezius F, Ziese T, et al. Migrainous vertigo: prevalence and impact on quality of life. Neurology. 2006;67:1028–33.CrossRefPubMed
36.
go back to reference Jacobson GP, Newman CW. The development of the dizziness handicap inventory. Arch Otolaryngol Head Neck Surg. 1990;116:424–7.CrossRefPubMed Jacobson GP, Newman CW. The development of the dizziness handicap inventory. Arch Otolaryngol Head Neck Surg. 1990;116:424–7.CrossRefPubMed
37.
go back to reference Yardley L, Masson E, Verschuur C, Haacke N, Luxon L. Symptoms, anxiety and handicap in dizzy patients: development of the vertigo symptom scale. J Psychosom Res. 1992;36:731–41.CrossRefPubMed Yardley L, Masson E, Verschuur C, Haacke N, Luxon L. Symptoms, anxiety and handicap in dizzy patients: development of the vertigo symptom scale. J Psychosom Res. 1992;36:731–41.CrossRefPubMed
38.
go back to reference Rabin R, de Charro F. EQ-5D: a measure of health status from the EuroQol Group. Ann Med. 2001;33:337–43.CrossRefPubMed Rabin R, de Charro F. EQ-5D: a measure of health status from the EuroQol Group. Ann Med. 2001;33:337–43.CrossRefPubMed
39.
go back to reference Richardson J, Day N, Peacock S, Lezzi A. Measurement of the quality of life for economic evaluation and the Assessment of Quality of Life (AQoL) Mark 2 instrument. Aust Econ Rev. 2004;37:62–88.CrossRef Richardson J, Day N, Peacock S, Lezzi A. Measurement of the quality of life for economic evaluation and the Assessment of Quality of Life (AQoL) Mark 2 instrument. Aust Econ Rev. 2004;37:62–88.CrossRef
40.
go back to reference Bronstein A, Lempert T. Dizziness. A practical approach to diagnosis and management. Cambridge: Cambridge Universtiy Press; 2007. Bronstein A, Lempert T. Dizziness. A practical approach to diagnosis and management. Cambridge: Cambridge Universtiy Press; 2007.
41.
go back to reference Chau AT, Menant JC, Hubner PP, Lord SR, Migliaccio AA. Prevalence of vestibular disorder in older people who experience dizziness. Front Neurol. 2015;6:268.CrossRefPubMedPubMedCentral Chau AT, Menant JC, Hubner PP, Lord SR, Migliaccio AA. Prevalence of vestibular disorder in older people who experience dizziness. Front Neurol. 2015;6:268.CrossRefPubMedPubMedCentral
42.
go back to reference Migliaccio AA, Della Santina CC, Carey JP, Niparko JK, Minor LB. The vestibulo-ocular reflex response to head impulses rarely decreases after cochlear implantation. Otol Neurotol. 2005;26:655–60.CrossRefPubMed Migliaccio AA, Della Santina CC, Carey JP, Niparko JK, Minor LB. The vestibulo-ocular reflex response to head impulses rarely decreases after cochlear implantation. Otol Neurotol. 2005;26:655–60.CrossRefPubMed
43.
go back to reference Migliaccio AA, Minor LB, Carey JP. Vergence-mediated modulation of the human angular vestibulo-ocular reflex is unaffected by canal plugging. Exp Brain Res. 2008;186:581–7.CrossRefPubMed Migliaccio AA, Minor LB, Carey JP. Vergence-mediated modulation of the human angular vestibulo-ocular reflex is unaffected by canal plugging. Exp Brain Res. 2008;186:581–7.CrossRefPubMed
44.
go back to reference Schubert MC, Tusa RJ, Grine LE, Herdman SJ. Optimizing the sensitivity of the head thrust test for identifying vestibular hypofunction. Phys Ther. 2004;84:151–8.PubMed Schubert MC, Tusa RJ, Grine LE, Herdman SJ. Optimizing the sensitivity of the head thrust test for identifying vestibular hypofunction. Phys Ther. 2004;84:151–8.PubMed
45.
go back to reference Kenny RA, Ingram A, Bayliss J, Sutton R. Head-up tilt: a useful test for investigating unexplained syncope. Lancet. 1986;1:1352–5.CrossRefPubMed Kenny RA, Ingram A, Bayliss J, Sutton R. Head-up tilt: a useful test for investigating unexplained syncope. Lancet. 1986;1:1352–5.CrossRefPubMed
46.
go back to reference Consensus statement on the definition of orthostatic hypotension, pure autonomic failure, and multiple system atrophy. The Consensus Committee of the American Autonomic Society and the American Academy of Neurology. Neurology. 1996;46:1470. Consensus statement on the definition of orthostatic hypotension, pure autonomic failure, and multiple system atrophy. The Consensus Committee of the American Autonomic Society and the American Academy of Neurology. Neurology. 1996;46:1470.
47.
go back to reference Lord SR, Menz HB, Tiedemann A. A physiological profile approach to falls risk assessment and prevention. Phys Ther. 2003;83:237–52.PubMed Lord SR, Menz HB, Tiedemann A. A physiological profile approach to falls risk assessment and prevention. Phys Ther. 2003;83:237–52.PubMed
48.
go back to reference Lord SR, Ward JA, Williams P, Anstey KJ. Physiological factors associated with falls in older community-dwelling women. J Am Geriatr Soc. 1994;42:1110–7.CrossRefPubMed Lord SR, Ward JA, Williams P, Anstey KJ. Physiological factors associated with falls in older community-dwelling women. J Am Geriatr Soc. 1994;42:1110–7.CrossRefPubMed
49.
go back to reference Lord SR, Ward JA, Williams P. Exercise effect on dynamic stability in older women: a randomized controlled trial. Arch Phys Med Rehabil. 1996;77:232–6.CrossRefPubMed Lord SR, Ward JA, Williams P. Exercise effect on dynamic stability in older women: a randomized controlled trial. Arch Phys Med Rehabil. 1996;77:232–6.CrossRefPubMed
50.
go back to reference Hausdorff JM, Rios DA, Edelberg HK. Gait variability and fall risk in community-living older adults: a 1-year prospective study. Arch Phys Med Rehabil. 2001;82:1050–6.CrossRefPubMed Hausdorff JM, Rios DA, Edelberg HK. Gait variability and fall risk in community-living older adults: a 1-year prospective study. Arch Phys Med Rehabil. 2001;82:1050–6.CrossRefPubMed
51.
go back to reference Delbaere K, Close JC, Mikolaizak AS, Sachdev PS, Brodaty H, Lord SR. The Falls Efficacy Scale International (FES-I). A comprehensive longitudinal validation study. Age Ageing. 2010;39:210–6.CrossRefPubMed Delbaere K, Close JC, Mikolaizak AS, Sachdev PS, Brodaty H, Lord SR. The Falls Efficacy Scale International (FES-I). A comprehensive longitudinal validation study. Age Ageing. 2010;39:210–6.CrossRefPubMed
52.
go back to reference Yardley L, Beyer N, Hauer K, Kempen G, Piot-Ziegler C, Todd C. Development and initial validation of the Falls Efficacy Scale-International (FES-I). Age Ageing. 2005;34:614–9.CrossRefPubMed Yardley L, Beyer N, Hauer K, Kempen G, Piot-Ziegler C, Todd C. Development and initial validation of the Falls Efficacy Scale-International (FES-I). Age Ageing. 2005;34:614–9.CrossRefPubMed
53.
go back to reference Spitzer RL, Kroenke K, Williams JB. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary care evaluation of mental disorders. Patient health questionnaire. JAMA. 1999;282:1737–44.CrossRefPubMed Spitzer RL, Kroenke K, Williams JB. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary care evaluation of mental disorders. Patient health questionnaire. JAMA. 1999;282:1737–44.CrossRefPubMed
54.
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;66:417–24.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;66:417–24.CrossRefPubMed
56.
go back to reference Persoons P, Luyckx K, Desloovere C, Vandenberghe J, Fischler B. Anxiety and mood disorders in otorhinolaryngology outpatients presenting with dizziness: validation of the self-administered PRIME-MD Patient Health Questionnaire and epidemiology. Gen Hosp Psychiatry. 2003;25:316–23.CrossRefPubMed Persoons P, Luyckx K, Desloovere C, Vandenberghe J, Fischler B. Anxiety and mood disorders in otorhinolaryngology outpatients presenting with dizziness: validation of the self-administered PRIME-MD Patient Health Questionnaire and epidemiology. Gen Hosp Psychiatry. 2003;25:316–23.CrossRefPubMed
57.
go back to reference Spitzer RL, Kroenke K, Williams JB, Lowe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166:1092–7.CrossRefPubMed Spitzer RL, Kroenke K, Williams JB, Lowe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166:1092–7.CrossRefPubMed
58.
go back to reference Costa PT, McCrae RR. NEO PI-R Professional Manual. Revised NEO Personality Inventory (NEO PI-R) and NEO Five-Factor Inventory (NEO-FFI). Odessa: Psychological Assessment Resources Inc.; 1992. Costa PT, McCrae RR. NEO PI-R Professional Manual. Revised NEO Personality Inventory (NEO PI-R) and NEO Five-Factor Inventory (NEO-FFI). Odessa: Psychological Assessment Resources Inc.; 1992.
59.
go back to reference Dear BF, Zou JB, Ali S, Lorian CN, Johnston L, Sheehan J, et al. Clinical and cost-effectiveness of therapist-guided internet-delivered cognitive behavior therapy for older adults with symptoms of anxiety: a randomized controlled trial. Behav Ther. 2015;46:206–17.CrossRefPubMed Dear BF, Zou JB, Ali S, Lorian CN, Johnston L, Sheehan J, et al. Clinical and cost-effectiveness of therapist-guided internet-delivered cognitive behavior therapy for older adults with symptoms of anxiety: a randomized controlled trial. Behav Ther. 2015;46:206–17.CrossRefPubMed
60.
go back to reference Staples LG, Fogliati VJ, Dear BF, Nielssen O, Titov N. Internet-delivered treatment for older adults with anxiety and depression: implementation of the Wellbeing Plus Course in routine clinical care and comparison with research trial outcomes. 2016. Staples LG, Fogliati VJ, Dear BF, Nielssen O, Titov N. Internet-delivered treatment for older adults with anxiety and depression: implementation of the Wellbeing Plus Course in routine clinical care and comparison with research trial outcomes. 2016.
61.
go back to reference Titov N, Fogliati VJ, Staples LG, Gandy M, Johnston L, Wootton BM, et al. Treating anxiety and depression in older adults: randomised controlled trial comparing guided v. self-guided internet-delivered cognitive-behavioural therapy. B J Psych Open. 2016;2:50–8.CrossRef Titov N, Fogliati VJ, Staples LG, Gandy M, Johnston L, Wootton BM, et al. Treating anxiety and depression in older adults: randomised controlled trial comparing guided v. self-guided internet-delivered cognitive-behavioural therapy. B J Psych Open. 2016;2:50–8.CrossRef
62.
go back to reference Campbell AJ, Robertson MC, Gardner MM, Norton RN, Buchner DM. Falls prevention over 2 years: a randomized controlled trial in women 80 years and older. Age Ageing. 1999;28:513–8.CrossRefPubMed Campbell AJ, Robertson MC, Gardner MM, Norton RN, Buchner DM. Falls prevention over 2 years: a randomized controlled trial in women 80 years and older. Age Ageing. 1999;28:513–8.CrossRefPubMed
63.
go back to reference Gardner MM, Buchner DM, Robertson MC, Campbell AJ. Practical implementation of an exercise-based falls prevention programme. Age Ageing. 2001;30:77–83.CrossRefPubMed Gardner MM, Buchner DM, Robertson MC, Campbell AJ. Practical implementation of an exercise-based falls prevention programme. Age Ageing. 2001;30:77–83.CrossRefPubMed
Metadata
Title
Tailored multifactorial intervention to improve dizziness symptoms and quality of life, balance and gait in dizziness sufferers aged over 50 years: protocol for a randomised controlled trial
Authors
Jasmine C. Menant
Americo A. Migliaccio
Cameron Hicks
Joanne Lo
Daniela Meinrath
Mayna Ratanapongleka
Jessica Turner
Daina L. Sturnieks
Kim Delbaere
Nickolai Titov
Catherine McVeigh
Jacqueline C. T. Close
Stephen R. Lord
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2017
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-017-0450-3

Other articles of this Issue 1/2017

BMC Geriatrics 1/2017 Go to the issue