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Predictors of dizziness in older persons: a 10-year prospective cohort study in the community.

Maarsingh OR, Stam H, van de Ven PM, van Schoor NM, Ridd MJ, van der Wouden JC - BMC Geriatr (2014)

Bottom Line: Population-based cohort study of 1,379 community-dwelling participants, aged ≥60 years, from the Longitudinal Aging Study Amsterdam (LASA).Both models showed good calibration (Hosmer-Lemeshow P value of 0.36 and 0.31, respectively) and acceptable discrimination (adjusted AUC after bootstrapping of 0.77 and 0.71).A multifactorial approach, targeting potentially modifiable predictors (e.g., physical exercise for impaired function of lower extremities), may add to the current diagnosis-oriented approach.

View Article: PubMed Central - PubMed

Affiliation: Department of General Practice & Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. o.maarsingh@vumc.nl.

ABSTRACT

Background: The current diagnosis-oriented approach of dizziness does not suit older patients. Often, it is difficult to identify a single underlying cause, and when a diagnosis is made, therapeutic options may be limited. Identification of predictors of dizziness may provide new leads for the management of dizziness in older patients. The aim of the present study was to investigate long-term predictors of regular dizziness in older persons.

Methods: Population-based cohort study of 1,379 community-dwelling participants, aged ≥60 years, from the Longitudinal Aging Study Amsterdam (LASA). Regular dizziness was ascertained during face-to-face medical interviews during 7- and 10-year follow-up. We investigated 26 predictors at baseline from six domains: socio-demographic, medical history, medication, psychological, sensory, and balance/gait. We performed multivariate logistic regression analyses with presence of regular dizziness at 7- and 10-year follow-up as dependent variables. We assessed the performance of the models by calculating calibration and discrimination.

Results: Predictors of regular dizziness at 7-year follow-up were living alone, history of dizziness, history of osteo/rheumatoid arthritis, use of nitrates, presence of anxiety or depression, impaired vision, and impaired function of lower extremities. Predictors of regular dizziness at 10-year follow-up were history of dizziness and impaired function of lower extremities. Both models showed good calibration (Hosmer-Lemeshow P value of 0.36 and 0.31, respectively) and acceptable discrimination (adjusted AUC after bootstrapping of 0.77 and 0.71).

Conclusions: Dizziness in older age was predicted by multiple factors. A multifactorial approach, targeting potentially modifiable predictors (e.g., physical exercise for impaired function of lower extremities), may add to the current diagnosis-oriented approach.

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Related in: MedlinePlus

Flowchart with dizziness prevalence at baseline, 7-year follow-up, and 10-year follow-up.
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Fig1: Flowchart with dizziness prevalence at baseline, 7-year follow-up, and 10-year follow-up.

Mentions: The present study was performed among a subsample of the LASA cohort, consisting of 1,379 participants who were aged 60 years or older. This group of 1,379 participants answered a (face-to-face) question on dizziness during the third data collection cycle of LASA (1998/1999; Figure 1). We used the fifth and sixth data collection cycles of LASA (2005/2006 and 2008/2009) to conduct a 7-year and 10-year follow-up on dizziness. The 7-year follow-up sample included 681 participants with valid data at baseline on dizziness, the 10-year follow-up sample included 512 participants with valid data at baseline on dizziness (Figure 1).Figure 1


Predictors of dizziness in older persons: a 10-year prospective cohort study in the community.

Maarsingh OR, Stam H, van de Ven PM, van Schoor NM, Ridd MJ, van der Wouden JC - BMC Geriatr (2014)

Flowchart with dizziness prevalence at baseline, 7-year follow-up, and 10-year follow-up.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4274723&req=5

Fig1: Flowchart with dizziness prevalence at baseline, 7-year follow-up, and 10-year follow-up.
Mentions: The present study was performed among a subsample of the LASA cohort, consisting of 1,379 participants who were aged 60 years or older. This group of 1,379 participants answered a (face-to-face) question on dizziness during the third data collection cycle of LASA (1998/1999; Figure 1). We used the fifth and sixth data collection cycles of LASA (2005/2006 and 2008/2009) to conduct a 7-year and 10-year follow-up on dizziness. The 7-year follow-up sample included 681 participants with valid data at baseline on dizziness, the 10-year follow-up sample included 512 participants with valid data at baseline on dizziness (Figure 1).Figure 1

Bottom Line: Population-based cohort study of 1,379 community-dwelling participants, aged ≥60 years, from the Longitudinal Aging Study Amsterdam (LASA).Both models showed good calibration (Hosmer-Lemeshow P value of 0.36 and 0.31, respectively) and acceptable discrimination (adjusted AUC after bootstrapping of 0.77 and 0.71).A multifactorial approach, targeting potentially modifiable predictors (e.g., physical exercise for impaired function of lower extremities), may add to the current diagnosis-oriented approach.

View Article: PubMed Central - PubMed

Affiliation: Department of General Practice & Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. o.maarsingh@vumc.nl.

ABSTRACT

Background: The current diagnosis-oriented approach of dizziness does not suit older patients. Often, it is difficult to identify a single underlying cause, and when a diagnosis is made, therapeutic options may be limited. Identification of predictors of dizziness may provide new leads for the management of dizziness in older patients. The aim of the present study was to investigate long-term predictors of regular dizziness in older persons.

Methods: Population-based cohort study of 1,379 community-dwelling participants, aged ≥60 years, from the Longitudinal Aging Study Amsterdam (LASA). Regular dizziness was ascertained during face-to-face medical interviews during 7- and 10-year follow-up. We investigated 26 predictors at baseline from six domains: socio-demographic, medical history, medication, psychological, sensory, and balance/gait. We performed multivariate logistic regression analyses with presence of regular dizziness at 7- and 10-year follow-up as dependent variables. We assessed the performance of the models by calculating calibration and discrimination.

Results: Predictors of regular dizziness at 7-year follow-up were living alone, history of dizziness, history of osteo/rheumatoid arthritis, use of nitrates, presence of anxiety or depression, impaired vision, and impaired function of lower extremities. Predictors of regular dizziness at 10-year follow-up were history of dizziness and impaired function of lower extremities. Both models showed good calibration (Hosmer-Lemeshow P value of 0.36 and 0.31, respectively) and acceptable discrimination (adjusted AUC after bootstrapping of 0.77 and 0.71).

Conclusions: Dizziness in older age was predicted by multiple factors. A multifactorial approach, targeting potentially modifiable predictors (e.g., physical exercise for impaired function of lower extremities), may add to the current diagnosis-oriented approach.

Show MeSH
Related in: MedlinePlus