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Kim E, Lee M, Park I. Risk of Obstructive Sleep Apnea, Chronic Dizziness, and Sleep Duration. Nurs Res 2024; 73:313-319. [PMID: 38498868 DOI: 10.1097/nnr.0000000000000733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
BACKGROUND Although it is recommended that obstructive sleep apnea (OSA) be screened for using a validated self-report questionnaire in patients experiencing dizziness, there is still a lack of research on the relationship between high risk of OSA and chronic dizziness. OBJECTIVES The study aimed to examine the relationship between the high risk of OSA and chronic dizziness and investigate how this relationship is affected by sleep duration. METHODS This cross-sectional study used data from the 8th Korea National Health and Nutrition Examination Survey (2019-2021). Adults aged 40 years or older were included and divided into two groups using the STOP-Bang Questionnaire (SBQ): a high-risk group for OSA or not. Complex samples logistic regression analyses were performed to examine the odds ratios of chronic dizziness based on the national population estimates. RESULTS Our findings showed that individuals in the high-risk group for OSA were significantly more likely to experience chronic dizziness. Specifically, among subgroups based on sleep duration, the high-risk group for OSA with a short sleep duration of ≤5 hours demonstrated the highest odds of chronic dizziness, showing a significantly 2.48-fold increased likelihood compared to the non-high risk for OSA with a sleep duration of 5-9 hours. DISCUSSION The SBQ can be beneficial when other causes do not explain chronic dizziness, helping to rule in the possibility of OSA. Educating individuals suspected of having OSA or who have been diagnosed with OSA about the importance of adequate sleep duration may help reduce the risk of chronic dizziness.
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Gallagher TJ, Jamal M, Choi JS. Association of Hearing Loss Onset and Etiology with Psychosocial Outcomes Among US Older Adults. Laryngoscope 2024. [PMID: 39031687 DOI: 10.1002/lary.31599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 05/15/2024] [Accepted: 06/06/2024] [Indexed: 07/22/2024]
Abstract
OBJECTIVE Understand the differential association of onset and etiology of hearing loss with psychosocial outcomes among older adults. METHODS This is a cross-sectional cohort study based on 2017-2020 National Health and Nutrition Examination Survey. Adults aged ≥70 years who completed audiometric testing and questionnaires on onset and etiologies of hearing loss were included (n = 612). Outcomes included report of social avoidance and major depressive disorder (MDD, PHQ-9). Multivariable regression was utilized to examine differential associations of onset and etiology of hearing loss on psychosocial outcomes while adjusting for relevant factors. RESULTS In this nationally representative sample of US older adults with hearing loss, 20.8% [95%CI: 14.5-29.0%] reported social avoidance due to hearing loss and 7.2% [95%CI: 4.3-11.8] reported symptoms suggestive of MDD. Multivariable regression demonstrated self-reported onset of hearing loss between ages 6-19 years (OR:2.49 [95%CI: 1.52-4.10]) and 20-59 years (OR:1.95 [95%CI: 1.07-3.55]) was associated with higher avoidance of social interaction than reported onset at ≥70 years. Those with onset between 20-59 years (OR:4.28 [95%CI: 1.17-15.6]) and 60-69 years (OR:5.68 [95%CI: 1.85-17.5]) were more likely to report symptoms consistent with MDD than those with onset at ≥70. Multivariable regression did not demonstrate increased risk of avoiding social interactions or MDD due to hearing loss from noise exposure, ear infection, or ear disease versus aging alone. CONCLUSION There was an association between earlier hearing loss onset with social avoidance and MDD. This suggests a need for research to investigate the impact of earlier diagnosis and intervention for hearing loss on psychosocial outcomes. LEVEL OF EVIDENCE 2b Laryngoscope, 2024.
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Affiliation(s)
- Tyler J Gallagher
- Keck School of Medicine of the University of Southern California, Los Angeles, California, U.S.A
| | - Malaika Jamal
- University of Southern California, Los Angeles, California, U.S.A
| | - Janet S Choi
- Caruso Department of Otolaryngology-Head & Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, U.S.A
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Grillo D, Zitti M, Cieślik B, Vania S, Zangarini S, Bargellesi S, Kiper P. Effectiveness of Telerehabilitation in Dizziness: A Systematic Review with Meta-Analysis. SENSORS (BASEL, SWITZERLAND) 2024; 24:3028. [PMID: 38793883 PMCID: PMC11125243 DOI: 10.3390/s24103028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 05/06/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024]
Abstract
Dizziness can be a debilitating condition with various causes, with at least one episode reported in 17% to 30% of the international adult population. Given the effectiveness of rehabilitation in treating dizziness and the recent advancements in telerehabilitation, this systematic review aims to investigate the effectiveness of telerehabilitation in the treatment of this disorder. The search, conducted across Medline, Cochrane Central Register of Controlled Trials, and PEDro databases, included randomized controlled trials assessing the efficacy of telerehabilitation interventions, delivered synchronously, asynchronously, or via tele-support/monitoring. Primary outcomes focused on dizziness frequency/severity and disability, with secondary outcomes assessing anxiety and depression measures. Seven articles met the eligibility criteria, whereas five articles contributed to the meta-analysis. Significant findings were observed regarding the frequency and severity of dizziness (mean difference of 3.01, p < 0.001), disability (mean difference of -4.25, p < 0.001), and anxiety (standardized mean difference of -0.16, p = 0.02), favoring telerehabilitation. Telerehabilitation shows promise as a treatment for dizziness, aligning with the positive outcomes seen in traditional rehabilitation studies. However, the effectiveness of different telerehabilitation approaches requires further investigation, given the moderate methodological quality and the varied nature of existing methods and programs.
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Affiliation(s)
- Davide Grillo
- Physical Medicine and Rehabilitation Unit, Azienda ULSS 3 Serenissima, 30126 Venice, Italy; (D.G.); (S.Z.); (S.B.)
| | - Mirko Zitti
- Healthcare Innovation Technology Lab, IRCCS San Camillo Hospital, 30126 Venezia, Italy; (M.Z.)
| | - Błażej Cieślik
- Healthcare Innovation Technology Lab, IRCCS San Camillo Hospital, 30126 Venezia, Italy; (M.Z.)
| | - Stefano Vania
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, 17100 Savona, Italy
| | - Silvia Zangarini
- Physical Medicine and Rehabilitation Unit, Azienda ULSS 3 Serenissima, 30126 Venice, Italy; (D.G.); (S.Z.); (S.B.)
| | - Stefano Bargellesi
- Physical Medicine and Rehabilitation Unit, Azienda ULSS 3 Serenissima, 30126 Venice, Italy; (D.G.); (S.Z.); (S.B.)
| | - Pawel Kiper
- Healthcare Innovation Technology Lab, IRCCS San Camillo Hospital, 30126 Venezia, Italy; (M.Z.)
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Ismail NM, Kabil SE, Abdel-Hamid EF. Otolithic functions in patients with residual dizziness after successful repositioning manoeuvres for unilateral posterior canal BPPV. J Int Med Res 2024; 52:3000605241249095. [PMID: 38726874 PMCID: PMC11089943 DOI: 10.1177/03000605241249095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/04/2024] [Indexed: 05/15/2024] Open
Abstract
OBJECTIVE To evaluate otolithic functions in patients with residual dizziness after successful canalith repositioning procedures (CRPs) for unilateral posterior canal benign paroxysmal positional vertigo (BPPV), and to investigate possible risk factors. METHODS This case-control observational study included healthy controls and patients with residual dizziness after improvement following CRP for BPPV. All participants were subjected to full history taking, otoscopy, audiological basic evaluation, Dix-Hallpike test to search for posterior canal BPPV, residual dizziness screening, and vestibular evoked myogenic potential (VEMP) testing. Between-group differences were assessed and possible factors associated with residual dizziness were identified by univariate analysis. RESULTS A total of 50 patients with residual dizziness (mean age, 56.53 ± 7.46 years [29 female: 21 male]) and 50 healthy controls (mean age, 58.13 ± 7.57 years [20 female: 30 male]) were included. A significant difference in VEMP latencies was found between the patient and control group (delayed in the patient group), with no significant between-group difference in amplitude in both ears. Aging, female sex, long duration of BPPV, number of CRPs, cervical VEMP and ocular VEMP abnormalities, and winter onset, were significantly associated with the risk of residual dizziness. CONCLUSIONS Residual dizziness is a frequent sequel of BPPV that may relate to otolithic dysfunction. VEMP changes were revealed in the form of delayed latencies.
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Affiliation(s)
- Naema M Ismail
- ENT Department, Faculty of Medicine (Girls), Al-Azhar University, Cairo, Egypt
| | - Shaimaa E Kabil
- ENT Department, Faculty of Medicine (Girls), Al-Azhar University, Cairo, Egypt
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Lindell E, Odhagen E, Tuomi L. Living with dizziness impacts health-related quality of life among older adults. Laryngoscope Investig Otolaryngol 2024; 9:e1194. [PMID: 38362202 PMCID: PMC10866590 DOI: 10.1002/lio2.1194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 10/16/2023] [Accepted: 11/26/2023] [Indexed: 02/17/2024] Open
Abstract
Objective This study aimed to compare older adults reporting dizziness to those not reporting dizziness regarding health-related quality of life (HRQL), distress due to dizziness, and balance confidence. A secondary aim was to investigate potential association between HRQL, number of falls, balance confidence, and distress due to dizziness. Methods Patients coming for bone density measurements answered questions regarding occurrence of dizziness. Patients reporting dizziness on a daily or weekly basis were considered eligible and invited for investigation at the Ear, Nose and Throat clinic at Södra Älvsborg Hospital, Sweden. Patients not reporting dizziness were considered eligible as controls. All patients answered the Dizziness Handicap Inventory (DHI), Activity Balance Confidence Scale (ABC-scale), and Euro-QoL-5D-3L questionnaires. Results A total of 55 dizzy patients came for physical investigation and answered the questionnaires and 47 non-dizzy participants only answered the questionnaires. The dizzy participants reported lower levels of balance confidence, lower HRQL, more prior falls, and higher levels of distress due to dizziness than the non-dizzy controls. Lower levels of balance confidence and higher level of distress due to dizziness were each associated with lower HRQL. Conclusion Dizziness, unsteadiness, and low balance confidence are associated with HRQL in a negative way. This is important to consider when measuring HRQL in a senior population, since a sensation of unsteadiness may indirectly contribute to low HRQL together with other symptoms. Level of evidence 2b.
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Affiliation(s)
- Ellen Lindell
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity of Gothenburg, Sahlgrenska Academy, Institute of Clinical SciencesGothenburgSweden
- Department of OtorhinolaryngologyRegion Västra Götaland, Södra Älvsborg HospitalBoråsSweden
- Department of Research, Education and InnovationRegion Västra Götaland, Södra Älvsborg HospitalBoråsSweden
| | - Erik Odhagen
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity of Gothenburg, Sahlgrenska Academy, Institute of Clinical SciencesGothenburgSweden
- Department of OtorhinolaryngologyRegion Västra Götaland, Södra Älvsborg HospitalBoråsSweden
- Department of Research, Education and InnovationRegion Västra Götaland, Södra Älvsborg HospitalBoråsSweden
| | - Lisa Tuomi
- Institute of Neuroscience and Physiology, Speech and Language Pathology UnitUniversity of Gothenburg, Sahlgrenska AcademyGothenburgSweden
- Department of Otorhinolaryngology, Head and Neck SurgeryRegion Västra Götaland, Sahlgrenska University HospitalGothenburgSweden
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Katzenberger B, Fuchs S, Schwettmann L, Strobl R, Hauser A, Koller D, Grill E. Association of self-efficacy, risk attitudes, and time preferences with functioning in older patients with vertigo, dizziness, and balance disorders in a tertiary care setting-Results from the MobilE-TRA2 cohort. Front Neurol 2023; 14:1316081. [PMID: 38162444 PMCID: PMC10755024 DOI: 10.3389/fneur.2023.1316081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024] Open
Abstract
Introduction The functional burden of vertigo, dizziness, and balance problems (VDB) might depend on the personality traits of the patients affected. The aim of this study thus was to investigate the impact of self-efficacy, risk attitudes, and time preferences on functioning in older patients with VDB before and after treatment in a specialized tertiary care center. Methods Data for this study was obtained from the MobilE-TRA2 cohort study, conducted at a specialized tertiary care center in Germany. Patients aged 60 and older were assessed during their initial stay at the care center and 3 months later, using self-administered questionnaires. Self-efficacy was measured on a scale from 1 (very low) to 5 (very high). Health-related risk attitudes were inquired using an 11-point scale. Time preferences were measured by evaluating patients' willingness to postpone a reward in favor of a greater benefit on an 11-point Likert scale. Functioning was evaluated using the Dizziness Handicap Inventory, representing functional, emotional, and physical aspects of functional disability caused by VDB. Mixed-effects regression models were used to analyze the association between the selected personality traits and functioning over time. Interaction terms with time were incorporated for each personality trait, enabling the assessment of their influence on functioning 3 months following the initial observation period. Results An overall of 337 patients (53% women, median age at baseline = 70 years) were included. Patients with higher self-efficacy (Beta = -3.82, 95%-CI [-6.56; -1.08]) and higher willingness to take risks (Beta = -1.31, 95%-CI [-2.31; -0.31]) reported better functioning during their initial visit at the care center. Self-efficacy significantly predicted functioning after 3 months for overall functioning (Beta = -4.21, 95%-CI [-6.57; -1.84]) and all three domains. Conclusion Our findings suggest that patients with high self-efficacy and high willingness to take risks may exhibit better coping mechanisms when faced with the challenges of VDB. Promoting self-efficacy may help patients to better manage the duties accompanying their treatment, leading to improved functioning. These insights may inform the development of personalized treatment aimed at reducing the functional burden of VDB in older patients.
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Affiliation(s)
- Benedict Katzenberger
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Sebastian Fuchs
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
- Department of Orthopaedics and Trauma Surgery, LMU University Hospital, LMU Munich, Munich, Germany
| | - Lars Schwettmann
- Department of Health Services Research, School of Medicine and Health Sciences, Carl Von Ossietzky University of Oldenburg, Oldenburg, Germany
- Institute of Health Economics and Health Care Management (IGM), Helmholtz Zentrum München (GmbH) – German Research Center for Environmental Health, Neuherberg, Germany
| | - Ralf Strobl
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany
- German Center for Vertigo and Balance Disorders, LMU University Hospital, LMU Munich, Munich, Germany
| | - Ari Hauser
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany
| | - Daniela Koller
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany
| | - Eva Grill
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany
- German Center for Vertigo and Balance Disorders, LMU University Hospital, LMU Munich, Munich, Germany
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Riato MLDC, Rocha VBC, Mezzalira R, Stoler G, do Amaral MIR. Validation and reliability analysis of the Questionnaire on the Emotional Impact of Vertigo-CIEV version translated to the Brazilian Portuguese language. Codas 2023; 35:e20220176. [PMID: 38055412 PMCID: PMC10750823 DOI: 10.1590/2317-1782/20232022176pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 11/03/2022] [Indexed: 12/08/2023] Open
Abstract
PURPOSE To determine the internal consistency and reliability of the "Questionário de Impacto Emocional da Vertigem (CIEV)" and to validate the instrument with respect to the Dizziness Handicap Inventory (DHI) in a sample of individuals with balance disorders. METHODS 38 subjects participated in the study, males and females, aged from 23 to 85 years, who presented dizziness, vertigo, and/or falls complaints and attended to the Vestibular Disorders clinic at the University Hospital. Individuals with hearing complaints and/or tinnitus unrelated to dizziness, previous psychiatric comorbidities, and/or cognitive impairments were excluded. We performed an anamnesis and collected complementary data from the medical records. After that, the self-perception questionnaires, DHI, and CIEV, were applied. Statistical analysis was performed in which the Cronbach's alpha verified the internal consistency of the CIEV. Reliability and validity of the CIEV related to the DHI were calculated using Intraclass Correlation Index (ICC) and Pearson's correlation test, respectively. RESULTS There was a statistically significant correlation between the scores obtained, for both reliability and validation analysis (p<0.001). The mean ICC showed a moderate correlation between the total scores (0.695) and a strong correlation with the physical, emotional, and functional DHI domains (0.706 to 0.869), being the emotional aspect the highest degree (0.869). Pearson's correlation showed strong correlation between the total scores (r=0.820) and varied from moderate to strong, with strongest correlations to the DHI emotional domain (r=0.788). CONCLUSION The outcomes illustrate important contribution to validation parameters to consider clinical use of the CIEV in the Brazilian population, aiming to identify emotional aspects in patients with balance disorders.
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Affiliation(s)
- Maria Luiza di Carlo Riato
- Programa de Graduação em Fonoaudiologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas - UNICAMP - Campinas (SP), Brasil.
- Departamento de Desenvolvimento Humano e Reabilitação, Faculdade de Ciências Médicas, Universidade Estadual de Campinas - UNICAMP - Campinas (SP), Brasil.
| | - Vanessa Brito Campoy Rocha
- Departamento de Otorrinolaringologia, Cabeça e Pescoço, Faculdade de Ciências Médicas, Universidade Estadual de Campinas - UNICAMP - Campinas (SP), Brasil.
| | - Raquel Mezzalira
- Departamento de Otorrinolaringologia, Cabeça e Pescoço, Faculdade de Ciências Médicas, Universidade Estadual de Campinas - UNICAMP - Campinas (SP), Brasil.
| | - Guita Stoler
- Departamento de Otorrinolaringologia, Cabeça e Pescoço, Faculdade de Ciências Médicas, Universidade Estadual de Campinas - UNICAMP - Campinas (SP), Brasil.
| | - Maria Isabel Ramos do Amaral
- Departamento de Desenvolvimento Humano e Reabilitação, Faculdade de Ciências Médicas, Universidade Estadual de Campinas - UNICAMP - Campinas (SP), Brasil.
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Hackenberg B, O'Brien K, Döge J, Lackner KJ, Beutel ME, Münzel T, Wild PS, Pfeiffer N, Chalabi J, Matthias C, Bahr‐Hamm K. Vertigo and its burden of disease-Results from a population-based cohort study. Laryngoscope Investig Otolaryngol 2023; 8:1624-1630. [PMID: 38130247 PMCID: PMC10731510 DOI: 10.1002/lio2.1169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 08/31/2023] [Accepted: 10/06/2023] [Indexed: 12/23/2023] Open
Abstract
Objectives Vertigo describes symptoms of abnormal movement of the environment or the patient's own body. As such, it affects patients' quality of life, prevents them from following their daily activities, and increases healthcare utilization. The Global Burden of Disease Project aims to quantify morbidity and mortality worldwide. In 2013, a separate disability weight for vertigo was introduced. The aim of this study is to estimate the symptom burden of disease caused by vertigo. Methods This study analyzes data from the Gutenberg Health Study (GHS). The GHS is a population-based cohort study representative of the city of Mainz and its district. Participants were asked whether they suffered from vertigo and, if so, how bothered they felt by it, rating their distress on a six-level scale from 1 = little stressful to 6 = extremely stressful. Results Eight thousand five hundred and nineteen participants could be included in the study. The overall prevalence of vertigo was 21.6% (95%-confidence interval [CI] [20.7%; 22.5%]). Vertigo prevalence peaked in the age group of 55-64 years. Vertigo annoyance averaged 2.42 (± 1.28). When an annoyance of 3-6 was considered bothersome, the prevalence of bothersome vertigo was 8.1 % (95%-CI [7.5%; 8.7%]). Age-standardized to the European Standard Population 2013, vertigo caused a burden of 2102 years lived with disability per 100,000 population. Conclusion In this study, it was found that one in five people suffer at least occasionally from vertigo. This result suggests a significant burden of disease. This burden is reported at the symptom level. Future studies are needed to attribute the burden to specific causes. Level of Evidence 2.
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Affiliation(s)
- Berit Hackenberg
- Department of OtorhinolaryngologyUniversity Medical Center MainzMainzGermany
| | - Karoline O'Brien
- Department of OtorhinolaryngologyUniversity Medical Center MainzMainzGermany
| | - Julia Döge
- Department of OtorhinolaryngologyUniversity Medical Center MainzMainzGermany
| | - Karl J. Lackner
- Institute for Clinical Chemistry and Laboratory MedicineUniversity Medical Center MainzMainzGermany
| | - Manfred E. Beutel
- Department of Psychosomatic Medicine and PsychotherapyUniversity Medical Center MainzMainzGermany
| | - Thomas Münzel
- Department of Cardiology—Cardiology IUniversity Medical Center MainzMainzGermany
| | - Philipp S. Wild
- Preventive Cardiology and Preventive Medicine—Department of CardiologyUniversity Medical Center MainzMainzGermany
- Center for Thrombosis and HemostasisUniversity Medical Center MainzMainzGermany
- DZHK (German Center for Cardiovascular Research), Partner Site RhineMainMainzGermany
- Institute of Molecular Biology (IMB)MainzGermany
| | - Norbert Pfeiffer
- Department of OphthalmologyUniversity Medical Center MainzMainzGermany
| | - Julian Chalabi
- Preventive Cardiology and Preventive Medicine—Department of CardiologyUniversity Medical Center MainzMainzGermany
| | - Christoph Matthias
- Department of OtorhinolaryngologyUniversity Medical Center MainzMainzGermany
| | - Katharina Bahr‐Hamm
- Department of OtorhinolaryngologyUniversity Medical Center MainzMainzGermany
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Ngo HTN, Maarsingh OR, van de Berg R, Blanker MH, Bruintjes TD, Castien R, Dijkstra R, Rutgers S, Slottje P, Twisk JWR, Yardley L, Bont J, van Vugt VA. Study protocol for a nationwide implementation of internet-based vestibular rehabilitation for patients with chronic vestibular symptoms (I-RECOVER). Implement Sci Commun 2023; 4:147. [PMID: 37993954 PMCID: PMC10666423 DOI: 10.1186/s43058-023-00524-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/01/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Vestibular rehabilitation is a safe and effective exercise-based treatment for patients with chronic vestibular symptoms. However, it is underused in general practice. Internet-based vestibular rehabilitation (Vertigo Training), which has proven to be effective as well, was developed to increase uptake. We now aim to improve the quality of care for patients with vestibular symptoms by carrying out a nationwide implementation of Vertigo Training. We will evaluate the effect of this implementation on primary care. METHODS Our implementation study consists of three successive phases: 1) We will perform a retrospective observational cohort study and a qualitative interview study to evaluate the current management of patients with vestibular symptoms in primary care, in particular anti-vertigo drug prescriptions, and identify areas for improvement. We will use the results of this phase to tailor our implementation strategy to the needs of general practitioners (GPs) and patients. 2) This phase entails the implementation of Vertigo Training using a multicomponent implementation strategy, containing: guideline adaptations; marketing strategy; pharmacotherapeutic audit and feedback meetings; education; clinical decision support; and local champions. 3) In this phase, we will evaluate the effect of the implementation in three ways. a. Interrupted time series. We will use routine primary care data from adult patients with vestibular symptoms to compare the number of GP consultations for vestibular symptoms, referrals for vestibular rehabilitation, prescriptions for anti-vertigo drugs, and referrals to physiotherapy and secondary care before and after implementation. b. Prospective observational cohort study. We will extract data from Vertigo Training to investigate the usage and the characteristics of participants. We will also determine whether these characteristics are associated with successful treatment. c. Qualitative interview study. We will conduct interviews with GPs to explore their experiences with the implementation. DISCUSSION This is one of the first studies to evaluate the effect of a nationwide implementation of an innovative treatment on Dutch primary care. Implementation strategies have been researched before, but it remains unclear which ones are the most effective and under what conditions. We therefore expect to gain relevant insights for future projects that aim to implement innovations in primary care.
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Affiliation(s)
- Hà T N Ngo
- Department of General Practice, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands.
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
| | - Otto R Maarsingh
- Department of General Practice, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Raymond van de Berg
- Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Marco H Blanker
- Department of Primary and Long-Term Care, University Medical Centre Groningen, Hanzeplein 1, Groningen, The Netherlands
| | - Tjasse D Bruintjes
- Department of Otorhinolaryngology, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Otorhinolaryngology, Gelre Hospital Apeldoorn, Apeldoorn, The Netherlands
| | - René Castien
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences Program Musculoskeletal Health, Amsterdam, The Netherlands
| | - Rob Dijkstra
- Department of General Practice, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
| | - Sandra Rutgers
- Patient Association Hoormij•NVVS, Houten, The Netherlands
| | - Pauline Slottje
- Department of General Practice, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Jos W R Twisk
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Lucy Yardley
- School of Psychology, University of Southampton, Southampton, UK
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Jettie Bont
- Department of General Practice, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Vincent A van Vugt
- Department of General Practice, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Garcia CB, Alves NGP, Bittar RSM. A new treatment for cervical dizziness. Braz J Otorhinolaryngol 2023; 89:101321. [PMID: 37716098 PMCID: PMC10509662 DOI: 10.1016/j.bjorl.2023.101321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/21/2023] [Accepted: 08/27/2023] [Indexed: 09/18/2023] Open
Abstract
OBJECTIVES To verify the rates of heat effectiveness generated by Carbon Nanotubes (CNT) in the resolution of dizziness in individuals diagnosed with Cervical Dizziness (CD). METHODS Randomized clinical trial was performed and samples from volunteers diagnosed with CD, divided into a Study Group (SG) and Control Group (CG). Patches containing CNT with thermotherapeutic effect were used in SG and inert patches in the CG. Treatment was performed over 30 days and measures of pain, dizziness and asymmetry of cervical muscle tension were evaluated over 60 days. RESULTS Pain, dizziness and asymmetry of cervical muscle tension were reduced in the SG. The variables analyzed in this study did not change in the CG. CONCLUSION Our results show that the therapeutic effect of heat was effective in the treatment of patients diagnosed with CD. We could also observe a clear interrelationship between pain and dizziness symptoms with the asymmetry of cervical muscle tension. LEVEL OF EVIDENCE 1B.
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Affiliation(s)
- Cesar Bertoldo Garcia
- Faculdade de Medicina da Universidade de São Paulo (FMUSP), Pós-Graduação em Medicina, São Paulo, SP, Brazil.
| | - Nedison Gomes Paim Alves
- Faculdade de Medicina da Universidade de São Paulo (FMUSP), Pós-Graduação em Ciências, São Paulo, SP, Brazil
| | - Roseli Saraiva Moreira Bittar
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC/FMUSP), Departamento de Otorrinolaringologia, Setor de Otoneurologia, São Paulo, SP, Brazil
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Obeidat FS, Alghwiri AA, Whitney SL. Predictors of Dizziness and Hearing Disorders in People with Long COVID. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1901. [PMID: 38003950 PMCID: PMC10673595 DOI: 10.3390/medicina59111901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/21/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: Individuals report persistent symptoms after becoming infected by SARS-CoV-2 (COVID-19) that last for >4 weeks (long-COVID syndrome). Dizziness and hearing loss have been reported among long-COVID symptoms. However, little is known about the potential predictors of dizziness and hearing loss in individuals with long COVID. This study aimed to explore the presence and correlates of dizziness and hearing loss in a sample of people with long-COVID syndrome. Materials and Methods: Individuals aged 18 years and older who were infected with COVID-19 at least 8 weeks prior to the start of the study were included if they were not diagnosed with dizziness or hearing loss before getting COVID-19. Demographics and COVID-19-related information were collected. Participants completed the Dizziness Handicap Inventory (DHI), Activities-Specific Balance Confidence (ABC) scale, Falls Efficacy Scale International (FES-I), Modified Fatigue Impact Scale (MFIS), and Medical Outcomes Study Short Form 12 (SF-12). Finally, hearing was assessed using pure-tone audiometry (PTA) in a subsample. Results: Two hundred and nine individuals (66% female) with a mean (SD) age of 27 (9) participated in the study. Perceived dizziness and hearing loss were reported in 26 and 15.3% of the sample, respectively. Logistic regression was conducted to identify potential predictors of dizziness and hearing loss separately. After controlling for age and severity of dizziness, female sex and high fatigue severity were associated with an increased likelihood of reporting dizziness (R2 = 31%). The severity of dizziness and neurological symptoms during the acute stage of COVID-19 were associated with an increased likelihood of reporting hearing loss (R2 = 10.4%) after controlling for age. Conclusions: Dizziness and hearing loss present in long COVID and can be disabling. Females with high levels of fatigue should be questioned about persistent dizziness. Hearing loss should be considered in individuals with neurological symptoms and severe dizziness as a consequence of long COVID.
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Affiliation(s)
- Faten S. Obeidat
- Department of Hearing and Speech Sciences, School of Rehabilitation Sciences, University of Jordan, Amman 11942, Jordan
| | - Alia A. Alghwiri
- Department of Physiotherapy, School of Rehabilitation Sciences, University of Jordan, Amman 11942, Jordan
| | - Susan L. Whitney
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA 15260, USA
- Department of Otolaryngology, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15260, USA
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Canturk T, Bery AK, Piccoli D, Pyche J, Czikk D, Osborne J, Pearson A, Bhatt C, Shin J, Chow L, Azzi JL, Tohme A, Caulley L, Lelli D, Tse D. Longitudinal Patient Outcomes in Chronic Dizziness: A Scoping Review. Otol Neurotol 2023; 44:848-852. [PMID: 37703893 DOI: 10.1097/mao.0000000000004000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
BACKGROUND Chronic dizziness can cause significant functional impairment. Outcome measures used in this patient population have not been examined systematically. Consequently, providers lack consensus on the ideal outcome measures to assess the impact of their interventions. OBJECTIVE AND METHODS We conducted a scoping review to summarize existing literature on outcomes in chronic dizziness (with a minimum of 6 mo of patient follow-up). Among other details, we extracted and analyzed patient demographics, medical condition(s), and the specific outcome measures of each study. RESULTS Of 19,426 articles meeting the original search terms, 416 met final exclusion after title/abstract and full-text review. Most studies focused on Ménière's disease (75%) and recurrent benign paroxysmal positional vertigo (21%). The most common outcome measures were hearing (62%) and number of attacks by American Academy of Otolaryngology-Head & Neck Surgery criteria (60%). A minority (35%) looked formally at quality-of-life metrics (Dizziness Handicap Index or other). CONCLUSIONS Ménière's disease and benign paroxysmal positional vertigo are overrepresented in literature on outcome assessment in chronic dizziness. Objective clinical measures are used more frequently than quality-of-life metrics. Future work is needed to identify the optimal outcome measures that reflect new knowledge about the most common causes of chronic dizziness (including persistent postural-perceptual dizziness and vestibular migraine) and consider what is most important to patients.
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Affiliation(s)
| | | | | | | | | | | | | | | | - John Shin
- Department of Otolaryngology-Head & Neck Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - Linda Chow
- Department of Otolaryngology-Head & Neck Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - Jayson Lee Azzi
- Department of Otolaryngology-Head & Neck Surgery, University of Manitoba, Manitoba, Canada
| | | | - Lisa Caulley
- Division of Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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Teggi R, Familiari M, Battista RA, Gatti O, Cangiano I, Bussi M, Bubbico L. The social problem of presbystasis and the role of vestibular rehabilitation in elderly patients: a review. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2023:1-8. [PMID: 37224169 PMCID: PMC10366565 DOI: 10.14639/0392-100x-n1908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 10/17/2022] [Indexed: 05/26/2023]
Affiliation(s)
- Roberto Teggi
- Department of Otolaryngology, Head and Neck Surgery, Scientific Institute of Hospitalization and Care San Raffaele Hospital, Vita - Salute University, Milan, Italy
| | - Marco Familiari
- Department of Otolaryngology, Head and Neck Surgery, Scientific Institute of Hospitalization and Care San Raffaele Hospital, Vita - Salute University, Milan, Italy
| | - Rosa Alessia Battista
- Department of Otolaryngology, Head and Neck Surgery, Scientific Institute of Hospitalization and Care San Raffaele Hospital, Vita - Salute University, Milan, Italy
| | - Omar Gatti
- Department of Otolaryngology, Head and Neck Surgery, Scientific Institute of Hospitalization and Care San Raffaele Hospital, Vita - Salute University, Milan, Italy
| | - Iacopo Cangiano
- Department of Otolaryngology, Head and Neck Surgery, Scientific Institute of Hospitalization and Care San Raffaele Hospital, Vita - Salute University, Milan, Italy
| | - Mario Bussi
- Department of Otolaryngology, Head and Neck Surgery, Scientific Institute of Hospitalization and Care San Raffaele Hospital, Vita - Salute University, Milan, Italy
| | - Luciano Bubbico
- Department of Sensorineural Disabilities, INAPP/Italian Institute of Social Medicine, Rome, Italy
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Mitchell MB, Bhattacharyya N. Balance Disorder Trends in US Adults 2008-2016: Epidemiology and Functional Impact. OTO Open 2023; 7:e58. [PMID: 37287493 PMCID: PMC10242407 DOI: 10.1002/oto2.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 05/13/2023] [Indexed: 06/09/2023] Open
Abstract
Objective To quantify the changes in prevalence and impact of dizziness and balance disorders in adults from 2008 to 2016. Study Design Epidemiological survey analysis. Setting United States. Methods The balance modules of the adult 2008 and 2016 National Health Interview Surveys were examined, and persons reporting dizziness or balance problems identified. The prevalence of balance problems was determined and compared over time, adjusting for age and sex. Among those with balance problems, associated symptoms and self-reported functional limitations were quantified and compared over time. Results In 2016, 36.8 ± 1.0 million (15.5% ± 0.3%) adults reported a balance problem in the past year, versus 24.2 ± 0.7 million (11.% ± 0.3%) in 2008 (p < .001). After adjustment for age and sex, this percentage increase remained significant (odds ratio 1.435 [1.332-1.546], p < .001). Among those with balance problems, significantly more patients reported specific issues with feeling: off-balance (69.4% vs. 65.4%; p = .005), faint (48.5% vs. 40.3%; p < .001), or vertiginous (45.9% vs. 39.3%; p < .001) in 2016 than 2008. More adults experienced anxiety (29.4% vs. 19.4%; p < .001) and depression (16.3% vs. 12.9%; p = .002) with their balance problems in 2016 than in 2008. In 2016, adults with balance problems were limited in ability to drive motor vehicles (13.0%), exercise (14.4%), or walk downstairs (12.8%). These rates were not significantly different from 2008 (all p > .05). Conclusion In this nationally representative analysis, we found a significantly increasing prevalence of balance problems and associated psychiatric symptom burden. This merits attention with respect to present and future health care resource allocation.
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Affiliation(s)
- Margaret B. Mitchell
- Department of Otolaryngology‐Head & Neck SurgeryMassachusetts Eye & EarBostonMassachusettsUSA
| | - Neil Bhattacharyya
- Department of Otolaryngology‐Head & Neck SurgeryMassachusetts Eye & EarBostonMassachusettsUSA
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Borsetto D, Corazzi V, Obholzer R, Bianchini C, Pelucchi S, Solmi M, Jiang D, Amin N, Pai I, Ciorba A. Dizziness, psychological disorders and cognitive decline. Panminerva Med 2023; 65:84-90. [PMID: 33988326 DOI: 10.23736/s0031-0808.21.04209-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Dizziness is a common disorder, particularly among the elderly population. Aim of this paper was to revise the current concepts surrounding the relationship between dizziness, psychological disorders and cognitive decline. EVIDENCE ACQUISITION This is a PRISMA-compliant systematic review, including observational studies in people with dizziness. Database inception, Medline/Cochrane/Embase/Web of Science/Scopus/NHS evidence were searched until October 30, 2019. EVIDENCE SYNTHESIS Overall 22 studies, and 65,730 participants were included. Eleven studies were cross-sectional, 7 cross-sectional controlled, 2 prospective case-control, 1 retrospective case series, and 1 cohort study. The persistence of vestibular impairment (for 6 months or more) was correlated to the presence of psychological disorders affecting patient's Quality of Life and causing social anxiety, particularly in some conditions such as Ménière's disease. Interestingly, vestibular loss has been also correlated to cognitive impairment, with certain vestibular dysfunctions reported to be more prevalent in cognitive impaired individuals. CONCLUSIONS The current literature suggests that there is an association between vestibular function, psychological disorders and cognitive functions. The findings from this review could be useful in informing on the need for a multidimensional diagnostic and rehabilitative programs for patients with dizziness. More studies could explore the role of counseling or behavioral therapy with an aim to reduce the perceived dizziness-related disability.
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Affiliation(s)
| | - Virginia Corazzi
- ENT and Audiology Department, University Hospital of Ferrara, Ferrara, Italy
| | | | - Chiara Bianchini
- ENT and Audiology Department, University Hospital of Ferrara, Ferrara, Italy
| | - Stefano Pelucchi
- ENT and Audiology Department, University Hospital of Ferrara, Ferrara, Italy
| | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada.,Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada
| | - Dan Jiang
- Guy's and St Thomas' Hospitals, London, UK
| | - Nikul Amin
- Guy's and St Thomas' Hospitals, London, UK
| | - Irumee Pai
- Guy's and St Thomas' Hospitals, London, UK
| | - Andrea Ciorba
- ENT and Audiology Department, University Hospital of Ferrara, Ferrara, Italy -
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Kar M, Özkan İ, Taylan S. The Effect of Modified Epley Maneuver Implementation on the Anxiety and Comfort Levels of Patients with Posterior Canal Bening Paroxysmal Positional Vertigo: A Prospective Study. Indian J Otolaryngol Head Neck Surg 2022; 74:3764-3772. [PMID: 36742479 PMCID: PMC9895533 DOI: 10.1007/s12070-021-02547-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 04/12/2021] [Indexed: 02/07/2023] Open
Abstract
To evaluate the effects of the modified Epley maneuver during Posterior Canal Benign Paroxysmal Positional Vertigo (BPPV) on patients' anxiety and comfort levels. The study, organized as a prospective, worked with 72 patients who were diagnosed with Posterior Canal BPPV through Dix-Hallpike maneuver. The data for the study was collected through Descriptive Characteristics Form, General Comfort Questionnaire Short Form, and Beck Anxiety Inventory. It was found that that 63.9% of the patients experienced average-level anxiety before the implementation of the Epley maneuver and received a total of 3.07 ± .37 (1-6) from the General Comfort Questionnaire. Before applying the modified Epley maneuver and I and IV When the score changes after the week were examined, it was determined that there was a statistically significant difference in all scale scores, as comfort levels increased, anxiety levels decreased. Anxiety was identified as the most important predictor of patients' comfort level before and after the implementation of the modified Epley maneuver. In light of these findings, it can be said that modified Epley maneuver can safely be used to increase the comfort of patients with Posterior Canal BPPV. Considering that patients with BPPV can consult to emergency rooms, family clinics along with polyclinics, it is recommended to organize regular trainings on BPPV and the implementation of the Epley maneuver. It is believed that evaluation of BPPV patients for their anxiety and offer support when needed is important for the prognosis and patients' comfort.
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Affiliation(s)
- Murat Kar
- Kumluca Public Hospital, Antalya, Turkey
| | - İlknur Özkan
- Kumluca Faculty of Health Sciences, İnternal Medicine Nursing Department, Akdeniz University, 07350 Kumluca, Antalya, Turkey
| | - Seçil Taylan
- Kumluca Faculty of Health Sciences, Surgical Nursing Department, Akdeniz University, Kumluca, Antalya, Turkey
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De Luca V, Femminella GD, Patalano R, Formosa V, Lorusso G, Rivetta C, Di Lullo F, Mercurio L, Rea T, Salvatore E, Korkmaz Yaylagul N, Apostolo J, Silva RC, Dantas C, van Staalduinen WH, Liotta G, Iaccarino G, Triassi M, Illario M. Assessment Tools of Biopsychosocial Frailty Dimensions in Community-Dwelling Older Adults: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16050. [PMID: 36498125 PMCID: PMC9739796 DOI: 10.3390/ijerph192316050] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/21/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
Frailty is a complex interplay between several factors, including physiological changes in ageing, multimorbidities, malnutrition, living environment, genetics, and lifestyle. Early screening for frailty risk factors in community-dwelling older people allows for preventive interventions on the clinical and social determinants of frailty, which allows adverse events to be avoided. By conducting a narrative review of the literature employing the International Narrative Systematic Assessment tool, the authors aimed to develop an updated framework for the main measurement tools to assess frailty risks in older adults, paying attention to use in the community and primary care settings. This search focused on the biopsychosocial domains of frailty that are covered in the SUNFRAIL tool. The study selected 178 reviews (polypharmacy: 20; nutrition: 13; physical activity: 74; medical visits: 0; falls: 39; cognitive decline: 12; loneliness: 15; social support: 5; economic constraints: 0) published between January 2010 and December 2021. Within the selected reviews, 123 assessment tools were identified (polypharmacy: 15; nutrition: 15; physical activity: 25; medical visits: 0; falls: 26; cognitive decline: 18; loneliness: 9; social support: 15; economic constraints: 0). The narrative review allowed us to evaluate assessment tools of frailty domains to be adopted for multidimensional health promotion and prevention interventions in community and primary care.
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Affiliation(s)
- Vincenzo De Luca
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Grazia Daniela Femminella
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Roberta Patalano
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Valeria Formosa
- Specializzazione in Igiene e Medicina Preventiva, Università degli Studi di Roma Tor Vergata, 00133 Roma, Italy
| | - Grazia Lorusso
- Specializzazione in Igiene e Medicina Preventiva, Università degli Studi di Roma Tor Vergata, 00133 Roma, Italy
| | - Cristiano Rivetta
- Specializzazione in Igiene e Medicina Preventiva, Università degli Studi di Roma Tor Vergata, 00133 Roma, Italy
| | - Federica Di Lullo
- Specializzazione in Igiene e Medicina Preventiva, Università degli Studi di Roma Tor Vergata, 00133 Roma, Italy
| | - Lorenzo Mercurio
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Teresa Rea
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Elena Salvatore
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | | | - Joao Apostolo
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Avenida Bissaya Barreto, 3004-011 Coimbra, Portugal
| | - Rosa Carla Silva
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Avenida Bissaya Barreto, 3004-011 Coimbra, Portugal
| | | | | | - Giuseppe Liotta
- Dipartimento di Biomedicina e Prevenzione, Università degli Studi di Roma Tor Vergata, 00133 Roma, Italy
| | - Guido Iaccarino
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Maria Triassi
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Maddalena Illario
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
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Marbaniang SP, Patel R, Kumar P, Chauhan S, Srivastava S. Hearing and vision difficulty and sequential treatment among older adults in India. Sci Rep 2022; 12:19056. [PMID: 36351946 PMCID: PMC9646738 DOI: 10.1038/s41598-022-21467-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 09/27/2022] [Indexed: 11/11/2022] Open
Abstract
Aging not only affect biomarker-related processes, but it also affects the physiological processes of the human body. Of all the physiological processes, hearing and vision are of utmost importance to a human. Therefore, this study examines the prevalence and factors associated with hearing and vision difficulty and their sequential treatment among older adults in India. Utilizing data from Building a Knowledge Base on Population Aging in India, study used two sets of outcome variables; firstly, self-reported hearing and vision difficulty and secondly, treatment-seeking for hearing and vision difficulty. A total of 9541 older adults aged 60+ years from seven major regionally representative states were selected. Descriptive statistics were used to perform preliminary analysis. Additionally, the study employed the Heckprobit selection model. It is a two-equation model. This model is used in order to accommodate the heterogeneity (i.e., shared unobserved factors) among older adults and then address the endogeneity (between hearing and vision loss problems and their treatment-seeking behaviour) for older adults in India, the model offers a two-step analysis and deals with the zero-sample issue. Around 59% and 21% of older adults reported vision and hearing difficulty, respectively. Only 5% of older adults suffering from hearing difficulty reported utilizing hearing aids. Lifestyle factors (smoking tobacco and chewing tobacco) significantly affect hearing and vision difficulty; various chronic diseases were also found to be associated with high levels of hearing and vision difficulty among older adults. Results from Heckprobit model shows that older adults with 11+ years of education had higher probability to use visual [β = 0.54, 95% confidence interval (CI): 0.37, 0.70] and hearing aids [β = 0.6, 95% CI: 0.18, 1.02]. The use of hearing and vision aids was lower among poor older adults, older adults from Scheduled Caste, and older adults in rural areas. The study indicates that more than half of older adults face vision difficulty and almost one-fourth face hearing difficulty in rural India, education and lifestyle appear to be the main driver of health-seeking behaviour. Additional attention shall be given to understand the strategies that may advocate a higher use for hearing aids among older adults.
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Affiliation(s)
| | - Ratna Patel
- grid.419349.20000 0001 0613 2600Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India
| | - Pradeep Kumar
- grid.419349.20000 0001 0613 2600Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, India
| | - Shekhar Chauhan
- grid.419349.20000 0001 0613 2600Department of Family and Generations, International Institute for Population Sciences, Mumbai, India
| | - Shobhit Srivastava
- grid.419349.20000 0001 0613 2600Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, India
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Referral trajectories in patients with vertigo, dizziness and balance disorders and their impact on health-related quality of life and functioning: results from the longitudinal multicenter study MobilE-TRA. J Neurol 2022; 269:6211-6221. [PMID: 35353231 PMCID: PMC9618552 DOI: 10.1007/s00415-022-11060-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 02/25/2022] [Accepted: 03/01/2022] [Indexed: 11/27/2022]
Abstract
Background Due to reported barriers in the management of patients with vertigo, dizziness and balance problems (VDB), referral trajectories starting from primary care might be determined by other factors than medical necessity. The objective of this paper was to examine the impact of disease-related and other determinants on referral trajectories of older patients with VDB and to investigate, how these trajectories affect the patients’ functioning and health-related quality of life (HRQoL). Methods Data originate from the longitudinal multicenter study MobilE-TRA, conducted in two German federal states. Referrals to neurologists or ear-nose-throat (ENT) specialists were considered. Referral patterns were visualized using a state sequence analysis. Predictors of referral trajectories were examined using a multinomial logistic regression model. Linear mixed models were calculated to assess the impact of referral patterns on the patients’ HRQoL and functioning. Results We identified three patterns of referral trajectories: primary care physician (PCP) only, PCP and neurologist, and PCP and ENT. Chances of referral to a neurologist were higher for patients with a neurological comorbidity (OR = 3.22, 95%-CI [1.003; 10.327]) and lower for patients from Saxony (OR = 0.08, 95%-CI [0.013; 0.419]). Patients with a PCP and neurologist referral pattern had a lower HRQoL and lower functioning at baseline assessment. Patients with unspecific diagnoses also had lower functioning. Conclusion Referral trajectories were determined by present comorbidities and the regional healthcare characteristics. Referral trajectories affected patients’ HRQoL. Unspecific VDB diagnoses seem to increase the risk of ineffective management and consequently impaired functioning. Supplementary Information The online version contains supplementary material available at 10.1007/s00415-022-11060-8.
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van Rie KJ, Kanji A, Naudé A. Professional Guidelines and Reported Practice of Audiologists Performing Fall Risk Assessment With Older Adults: A Systematic Review. Am J Audiol 2022; 31:243-260. [PMID: 35148482 DOI: 10.1044/2021_aja-21-00148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE This systematic review aimed to explore the recommended fall risk assessment practices in audiology, identify audiologists' reported practices in fall risk assessment, and recognize the barriers and facilitators affecting fall risk assessment in clinical practice. METHOD This systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. RESULTS CINAHL, PubMed, and gray literature yielded 262 articles. A total of 27 full-text articles were included in this review article. An additional 16 scope of practice and guideline documents were also reviewed. Pertinent data and findings from the review were tabulated and analyzed using a qualitative, inductive approach. CONCLUSIONS Results revealed that despite fall risk assessment measures and protocols being mentioned, discussed, and reportedly implemented clinically in audiology literature, many audiologists are not conducting fall risk assessments clinically. The main challenges presented appear to be due to limited guidance within audiology documentation and inadequate training and knowledge of audiologists on fall risk factors and measures. This review article highlighted that all audiologists have an important role to play in reducing the global crisis of falls in older adults. However, without further research to aid in the development of standardization of documentation and training programs, we may continue to see a lack of awareness and education on fall risk and on the audiologist's role in the screening and early detection hereof.
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Affiliation(s)
- Kayla J. van Rie
- Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Amisha Kanji
- Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Alida Naudé
- Centre for Augmentative and Alternative Communication, Faculty of Humanities, University of Pretoria, South Africa
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22
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Paiva MMD, Lima MG, Barros MBDA. [Falls and health-related quality of life: influence of frequency and location type of falls]. CIENCIA & SAUDE COLETIVA 2021; 26:5099-5108. [PMID: 34787202 DOI: 10.1590/1413-812320212611.3.29902019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 11/03/2019] [Indexed: 11/22/2022] Open
Abstract
This article aims to evaluate health-related quality of life (HRQOL) according to the frequency and characteristics of falls in the elderly. A cross-sectional study was carried out with data from a household health survey conducted in 2014 and 2015, in Campinas, SP. The dependent variables were the SF-36 domains and, the independent ones, the occurrence and the characteristics of the falls. The mean and mean differences of the SF-36 scores were estimated by simple and multiple linear regression. The study reveals that the impact on HRQOL depends significantly on the characteristics of falls. Larger declines and a greater number of SF-36 domains were observed in the elderly who suffered three or more falls (compared to those with one or two falls), reporting falls from fainting/dizziness (compared to falls due to tripping), those who fell at home (versus falls occurring elsewhere) and reported falling limitation in daily activities. Only in the falls with these characteristics did the domain of emotional aspects be affected. The impact on HRQoL, including emotional aspects, depends on the characteristics of the falls that need to be considered in prevention actions and in the control of the consequences of falls in the quality of life of the elderly.
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Affiliation(s)
- Mariana Mapelli de Paiva
- Departamento de Saúde Coletiva, Faculdade de Ciências Médicas, Universidade Estadual de Campinas. R. Tessália Vieira de Camargo 126, Cidade Universitária Zeferino Vaz. 13083-887 Campinas SP Brasil. .,Instituto Federal do Norte de Minas Gerais, Campus Almenara. Almenara MG Brasil
| | - Margareth Guimarães Lima
- Departamento de Saúde Coletiva, Faculdade de Ciências Médicas, Universidade Estadual de Campinas. R. Tessália Vieira de Camargo 126, Cidade Universitária Zeferino Vaz. 13083-887 Campinas SP Brasil.
| | - Marilisa Berti de Azevedo Barros
- Departamento de Saúde Coletiva, Faculdade de Ciências Médicas, Universidade Estadual de Campinas. R. Tessália Vieira de Camargo 126, Cidade Universitária Zeferino Vaz. 13083-887 Campinas SP Brasil.
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23
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Lindell E, Kollén L, Johansson M, Karlsson T, Rydén L, Fässberg MM, Erhag HF, Skoog I, Finizia C. Dizziness and health-related quality of life among older adults in an urban population: a cross-sectional study. Health Qual Life Outcomes 2021; 19:231. [PMID: 34600557 PMCID: PMC8487566 DOI: 10.1186/s12955-021-01864-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 09/15/2021] [Indexed: 11/10/2022] Open
Abstract
Background Dizziness is a common complaint among older adults and may affect quality of life in a negative way. The aim of this study was to assess health-related quality of life (HRQL), sense of coherence (SOC), self-rated health (SRH) and comorbidity in relation to dizziness, among older persons from an urban population. Methods The study is part of the Gothenburg H70 Birth Cohort Studies (H70). A cross-sectional population-based sample including 662 79-years-olds (404 women, 258 men, 62% response rate) were surveyed with questions regarding dizziness, imbalance, comorbidities and general health. HRQL was assessed using the 36-item Short Form-36 Health Survey (SF-36) and SOC with the 13-items questionnaire Sense of Coherence (SOC-13). Results Half of the participants reported problems with dizziness (54%). Dizziness was negatively associated with HRQL, including after adjusting for comorbidities, especially in the physical domains of SF-36. Having dizziness was also associated with poorer SRH, tiredness and comorbidity among both men and women. SOC (mean total score), however, did not differ between dizzy and non-dizzy participants. Conclusions Dizziness was negatively associated with HRQL, also after adjusting for comorbidities. Identification and treatment of dizziness, when possible, are important because reduction of dizziness symptoms may potentially help to enhance overall well-being in this age group.
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Affiliation(s)
- Ellen Lindell
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska Universitetssjukhuset, Gothenburg University, Gröna Stråket 5, 413 45, Gothenburg, Sweden. .,Department of Otorhinolaryngology, Region Västra Götaland, Sahlgrenska University Hospital, 413 45, Gothenburg, Sweden.
| | - Lena Kollén
- Department of Otorhinolaryngology, Region Västra Götaland, Sahlgrenska University Hospital, 413 45, Gothenburg, Sweden.,Department of Occupational Therapy and Physiotherapy, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, 413 45, Gothenburg, Sweden
| | - Mia Johansson
- Department of Otorhinolaryngology, Region Västra Götaland, Sahlgrenska University Hospital, 413 45, Gothenburg, Sweden.,Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, 413 45, Gothenburg, Sweden
| | - Therese Karlsson
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska Universitetssjukhuset, Gothenburg University, Gröna Stråket 5, 413 45, Gothenburg, Sweden.,Department of Otorhinolaryngology, Region Västra Götaland, Sahlgrenska University Hospital, 413 45, Gothenburg, Sweden
| | - Lina Rydén
- Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), University of Gothenburg, Gothenburg, Sweden
| | - Madeleine Mellqvist Fässberg
- Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), University of Gothenburg, Gothenburg, Sweden
| | - Hanna Falk Erhag
- Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), University of Gothenburg, Gothenburg, Sweden
| | - Ingmar Skoog
- Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), University of Gothenburg, Gothenburg, Sweden
| | - Caterina Finizia
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska Universitetssjukhuset, Gothenburg University, Gröna Stråket 5, 413 45, Gothenburg, Sweden.,Department of Otorhinolaryngology, Region Västra Götaland, Sahlgrenska University Hospital, 413 45, Gothenburg, Sweden
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24
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Rizk HG, Liu YF. Interviewing and Counseling the Dizzy Patient with Focus on Quality of Life. Otolaryngol Clin North Am 2021; 54:853-861. [PMID: 34294434 DOI: 10.1016/j.otc.2021.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
When interviewing a patient presenting with dizziness, it is imperative to both diagnosis and treatment for the clinician to identify the impact dizziness has on the patient's productivity, general function level and cognition. and cognition. Psychiatric comorbidities and concurrent sleep disturbances are common in this patient population and identification of these additional factors is important in implementing a holistic, multidisciplinary treatment plan and ultimately improves the patient's outcome.
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Affiliation(s)
- Habib G Rizk
- Department of Otolaryngology, Medical University of South Carolina, Otolaryngology H&N Surgery, 135 Rutledge Avenue, MSC 550, Charleston, SC 29425, USA.
| | - Yuan F Liu
- Department of Otolaryngology, Loma Linda University Health, 11234 Anderson Street, Room: 2586A, Loma Linda, CA 92354, USA
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25
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[Quality of primary care and quality of life from the point of view of older patients with dizziness. Results oft the cohort study MobilE-TRA]. MMW Fortschr Med 2021; 163:11-18. [PMID: 33844180 DOI: 10.1007/s15006-021-9703-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND The treatment of elderly patients with dizziness/vertigo/balance disorders (VDB) can be challenging for their general practitioner. Patient-centered care with a focus on self-management support could be a possible approach. Primary objective of this study was to investigate the correlations between quality of primary care and health-related quality of life (HRQOL) from the patient's perspective. METHOD Data had been collected in the area of Munich and in the area of Dresden between 2017 and 2019. Questionnaires of n = 157 elderly patients from primary care practices in Munich and Dresden were evaluated. Multiple linear regression was used to analyse quality of care, physical activity, depression, and their correlations with HRQOL. RESULTS In this cohort of patients aged 65 to 94 no significant correlation between quality of care and HRQOL could be detected. Depression correlated negatively with HRQOL, whereas physical activity showed a positive correlation with HRQOL. CONCLUSIONS Physical activity can be beneficial for elderly dizzy patients' HRQOL. Additionally, a potential depression should be taken into account when treating patients with dizziness to improve their HRQOL. The results can be well transferred to elderly patients with VDB. Analysing more patients however, could increase the significance of the results.
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Mullin N, Mcphee O, Morrow C, Youssef A. Assessment, diagnosis and management of the dizzy patient. Br J Hosp Med (Lond) 2020; 81:1-7. [PMID: 33377841 DOI: 10.12968/hmed.2020.0469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Dizziness and balance disorders are very common problems. Having a structured approach, including adequate history taking and clinical examination, in a multidisciplinary environment allows for effective management of patients with these complex symptoms. Hearing assessment is an integral part of the assessment of patients with dizziness, along with the occasional need for further testing. Identifying red flags, along with the ability to involve different medical specialties, are prerequisites for safe management and a successful outcome. While surgical intervention has a small role in the management of balance disorders, vestibular rehabilitation remains the cornerstone of treatment, along with different supportive measures. This article outlines the approach used in the authors' centre to manage patients with dizziness and balance disorders.
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Affiliation(s)
- Nova Mullin
- Balance Unit, ENT Department, Liverpool University Hospitals, Liverpool, UK
| | - Olivia Mcphee
- Balance Unit, ENT Department, Liverpool University Hospitals, Liverpool, UK
| | - Cathie Morrow
- Balance Unit, ENT Department, Liverpool University Hospitals, Liverpool, UK
| | - Ahmed Youssef
- Balance Unit, ENT Department, Liverpool University Hospitals, Liverpool, UK
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Soto-Varela A, Rossi-Izquierdo M, Del-Río-Valeiras M, Vaamonde-Sánchez-Andrade I, Faraldo-García A, Lirola-Delgado A, Santos-Pérez S. Presbyvestibulopathy, Comorbidities, and Perception of Disability: A Cross-Sectional Study. Front Neurol 2020; 11:582038. [PMID: 33250848 PMCID: PMC7673369 DOI: 10.3389/fneur.2020.582038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 10/08/2020] [Indexed: 11/23/2022] Open
Abstract
Objective: To assess the perception of disability in patients with presbyvestibulopathy and to determine the factors (demographic, balance test scores, and comorbidities) that determine higher levels of disability. Material and Methods: This was a cross-sectional study conducted in a tertiary university hospital. There were 103 patients who fulfilled the diagnostic criteria for presbyvestibulopathy and were included. Dizziness Handicap Inventory (DHI) score was the main variable used to quantify disability. Influence on DHI score, sex, age, time of evolution, equilibriometric parameters (posturographic scores and timed up and go test), history of falls, comorbidities (high blood pressure, diabetes, and dyslipidemia), psychotropic drug use, tobacco or alcohol use, living environment (urban or rural), and active lifestyle were analyzed. Results: Most of the DHI scores showed a moderate (46 patients, 44.7%) or severe (39 participants, 37.9%) handicap. DHI scores were higher in women (59.8 vs. 36.1, p < 0.001), patients with obesity (58.92 vs. 48.68; p = 0.019), benzodiazepine (59.9 vs. 49.1, p = 0.008) or other psychotropic drug (60.7 vs. 49.2, p = 0.017) users, and fallers (57.1 vs. 47.3, p = 0.048). There was also a significant positive correlation between DHI score, time (Rho coefficient: 0.371, p < 0.001), and steps (Rho coefficient: 0.284, p = 0.004) used in the TUG and with the short FES-I questionnaire (a shortened version of the Falls Efficacy Scale-International) score (Rho coefficient: 0.695, p < 0.001). DHI scores were lower in alcohol consumers than in non-drinkers (46.6 vs. 56, p = 0.048). No significant correlation was found between DHI scores and age, time of evolution, posturographic scores, comorbidities, environment (rural or urban), or active lifestyle. Conclusion: Most patients with presbyvestibulopathy show an important subjective perception of disability in relation to their symptoms. This perception is substantially higher in women than in men. The most influential factors are difficulties in walking, fear of falling, and obesity. Unique Identifier: NCT03034655, www.clinicaltrials.gov.
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Affiliation(s)
- Andrés Soto-Varela
- Division of Neurotology, Department of Otorhinolaryngology, Complexo Hospitalario Universitario, Santiago de Compostela, Spain.,Department of Surgery and Medical-Surgical Specialities, University of Santiago de Compostela, Santiago de Compostela, Spain
| | | | - María Del-Río-Valeiras
- Department of Otorhinolaryngology, Complexo Hospitalario Universitario, Santiago de Compostela, Spain
| | | | - Ana Faraldo-García
- Department of Otorhinolaryngology, Complexo Hospitalario Universitario, Santiago de Compostela, Spain
| | - Antonio Lirola-Delgado
- Department of Otorhinolaryngology, Complexo Hospitalario Universitario, Santiago de Compostela, Spain
| | - Sofía Santos-Pérez
- Division of Neurotology, Department of Otorhinolaryngology, Complexo Hospitalario Universitario, Santiago de Compostela, Spain.,Department of Surgery and Medical-Surgical Specialities, University of Santiago de Compostela, Santiago de Compostela, Spain
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Fei Y, Zheng Y, Meng H, Li G, Zhong P, Lu J. Clinical practicality of the dizziness handicap inventory for evaluating dizziness in the Mandarin Chinese-speaking population: a prospective cross-sectional analysis. Int J Audiol 2020; 60:532-538. [PMID: 33161798 DOI: 10.1080/14992027.2020.1839677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To explore the clinical practicality of the dizziness handicap inventory (DHI) in the Mandarin Chinese-speaking population and compare patients' and physicians' assessments of the impact of dizziness on the quality of life using the DHI. DESIGN Prospective cross-sectional. STUDY SAMPLE Overall, 144 consecutive patients aged ≥ 18 years seeking treatment for dizziness in an Ear-Nose-Throat clinic in China. RESULTS Some items in the DHI could not be completed by both patients (46/144, 31.9%) and physicians (26/144, 18.1%). In fully completed DHIs (98/144, 68.1%), the patients' self-assessment scores were higher than the physicians' assessment scores (average 44.04 ± 21.38 vs 35.94 ± 16.99; p < 0.05). The strength of the correlation between the patients' and physicians' total DHI scores was high (r = 0.80; p < 0.05). Moreover, at a cut-off point of 18, the discrepancy scores of 77.6% (76/98) of the cases did not exceed the minimum detectable change (MDC) of the DHI. CONCLUSIONS The clinical practicality of the DHI in such settings requires improvement. Even though physician interviews can increase the degree of questionnaire completion, not all items can be completed. Although the physicians' assessment scores were lower than the patients' self-assessment scores, the majority of the discordancy scores were within the MDC of the DHI.
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Affiliation(s)
- Yingping Fei
- Department of Otolaryngology-Head and Neck Surgery, Hearing center/Hearing & Speech Science Laboratory, West China Hospital of Medicine Sichuan University, Chengdu, China
| | - Yun Zheng
- Department of Otolaryngology-Head and Neck Surgery, Hearing center/Hearing & Speech Science Laboratory, West China Hospital of Medicine Sichuan University, Chengdu, China
| | - Hongdao Meng
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Gang Li
- Department of Otolaryngology-Head and Neck Surgery, Hearing center/Hearing & Speech Science Laboratory, West China Hospital of Medicine Sichuan University, Chengdu, China
| | - Ping Zhong
- Department of Otolaryngology-Head and Neck Surgery, Hearing center/Hearing & Speech Science Laboratory, West China Hospital of Medicine Sichuan University, Chengdu, China
| | - Jingzhe Lu
- Department of Otolaryngology-Head and Neck Surgery, Hearing center/Hearing & Speech Science Laboratory, West China Hospital of Medicine Sichuan University, Chengdu, China
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van Vugt VA, Bosmans JE, Finch AP, van der Wouden JC, van der Horst HE, Maarsingh OR. Cost-effectiveness of internet-based vestibular rehabilitation with and without physiotherapy support for adults aged 50 and older with a chronic vestibular syndrome in general practice. BMJ Open 2020; 10:e035583. [PMID: 33060078 PMCID: PMC7566722 DOI: 10.1136/bmjopen-2019-035583] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 06/25/2020] [Accepted: 08/21/2020] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES To evaluate the cost-effectiveness of stand-alone and blended internet-based vestibular rehabilitation (VR) in comparison with usual care (UC) for chronic vestibular syndromes in general practice. DESIGN Economic evaluation alongside a three-armed, individually randomised controlled trial. SETTING 59 Dutch general practices. PARTICIPANTS 322 adults, aged 50 years and older with a chronic vestibular syndrome. INTERVENTIONS Stand-alone VR consisted of a 6-week, internet-based intervention with weekly online sessions and daily exercises. In blended VR, this intervention was supplemented with face-to-face physiotherapy support. UC group participants received usual general practice care without restrictions. MAIN OUTCOME MEASURES Societal costs, quality-adjusted life years (QALYs), Vertigo Symptom Scale-Short Form (VSS-SF), clinically relevant response (≥3 points VSS-SF improvement). RESULTS Mean societal costs in both the stand-alone and blended VR groups were statistically non-significantly higher than in the UC group (mean difference (MD) €504, 95% CI -1082 to 2268; and €916, 95% CI -663 to 2596). Both stand-alone and blended VR groups reported non-significantly more QALYs than the UC group (MD 0.02, 95% CI -0.00 to 0.04; and 0.01, 95% CI -0.01 to 0.03), and significantly better VSS-SF Scores (MD 3.8 points, 95% CI 1.7 to 6.0; and 3.3 points, 95% CI 1.3 to 5.2). For stand-alone VR compared with UC, the probability of cost-effectiveness was 0.95 at a willingness-to-pay ratio of €24 161/QALY, €600/point improvement in VSS-SF and €8000/clinically relevant responder in VSS-SF. For blended VR versus UC, the probability of cost-effectiveness was 0.95 at a willingness-to-pay ratio of €123 335/QALY, €900/point improvement in VSS-SF and €24 000/clinically relevant responder in VSS-SF. CONCLUSION Stand-alone and blended internet-based VR non-significantly increased QALYs and significantly reduced vestibular symptoms compared with UC, while costs in both groups were non-significantly higher. Stand-alone VR has the highest probability to be cost-effective compared with UC. TRIAL REGISTRATION NUMBER The Netherlands Trial Register NTR5712.
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Affiliation(s)
- Vincent A van Vugt
- Department of General Practice, Amsterdam UMC - Location VUMC, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Judith E Bosmans
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Aureliano P Finch
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Johannes C van der Wouden
- Department of General Practice, Amsterdam UMC - Location VUMC, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Henriëtte E van der Horst
- Department of General Practice, Amsterdam UMC - Location VUMC, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Otto R Maarsingh
- Department of General Practice, Amsterdam UMC - Location VUMC, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Vozel D, Steiner N, Božanić Urbančič N, Mladenov D, Battelino S. Slovenian Cross-Cultural Adaptation and Validation of Health-Related Quality of Life Measures for Chronic Otitis Media (COMQ-12), Vertigo (DHI, NVI) and TINNITUS (THI). Zdr Varst 2020; 59:120-127. [PMID: 32952712 PMCID: PMC7478096 DOI: 10.2478/sjph-2020-0016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 04/02/2020] [Indexed: 12/15/2022] Open
Abstract
PURPOSE To provide physicians and patients with the tools needed to evaluate patients' problems and health-related quality of life by cross-culturally adapting and validating the Chronic Otitis Media Questionnaire 12 (COMQ-12), the Dizziness Handicap Inventory (DHI), the Neuropsychological Vertigo Inventory (NVI) and the Tinnitus Handicap Inventory (THI). MATERIALS AND METHODS COMQ-12, DHI, NVI and THI were translated into the Slovenian language and completed by patients treated at our department for chronic otitis media, vertigo or tinnitus. The control group for each questionnaire consisted of healthy volunteers. Internal consistency, test-retest reliability, discriminant validity, diagnostic accuracy and cut-off value were determined for each questionnaire. RESULTS Test-retest reliability was excellent for DHI (ICC A=0.946) and NVI (p=0.315, ICC A=0.975), good to excellent for COMQ-12 (p=0.680, ICC A=0.858) and satisfactory for THI (p=0.120). Discriminant validity was confirmed for each questionnaire (p>0.05) using the Mann-Whitney U test (COMQ-12, DHI, THI) or the Welch t-test (NVI). COMQ-12 had acceptable (α=0.796) and DHI (α=0.910), NVI (α=0.950) and THI (α=0.924) perfect internal consistency. COMQ-12 and DHI had excellent, NVI acceptable and THI perfect diagnostic accuracy (AUC=0.987, AUC=0.999, AUC=0.781 and AUC=1.000 respectively). Cut-off values determined by Youden's index were 7, 7, 9 and 56 for COMQ-12, THI, DHI and NVI, respectively. CONCLUSION Slovenian COMQ-12, DHI, NVI and THI are a valid and accurate tool for the diagnosis and measurement of health-related quality of life in patients with chronic otitis media, vertigo and tinnitus. They could aid general practitioners, occupational health specialists, neurologists and otorhinolaryngologists.
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Affiliation(s)
- Domen Vozel
- University Medical Centre Ljubljana, Department of Otorhinolaryngology and Cervicofacial Surgery, Zaloška 2, 1000Ljubljana, Slovenia
- University of Ljubljana, Faculty of Medicine, Department of Otorhinolaringology, Vrazov trg 2, 1000Ljubljana, Slovenia
| | - Nejc Steiner
- University Medical Centre Ljubljana, Department of Otorhinolaryngology and Cervicofacial Surgery, Zaloška 2, 1000Ljubljana, Slovenia
| | - Nina Božanić Urbančič
- University Medical Centre Ljubljana, Department of Otorhinolaryngology and Cervicofacial Surgery, Zaloška 2, 1000Ljubljana, Slovenia
- University of Ljubljana, Faculty of Medicine, Department of Otorhinolaringology, Vrazov trg 2, 1000Ljubljana, Slovenia
| | - Dejan Mladenov
- Železniški zdravstveni dom Ljubljana, Celovška cesta 4, 1000Ljubljana, Slovenia
| | - Saba Battelino
- University Medical Centre Ljubljana, Department of Otorhinolaryngology and Cervicofacial Surgery, Zaloška 2, 1000Ljubljana, Slovenia
- University of Ljubljana, Faculty of Medicine, Department of Otorhinolaringology, Vrazov trg 2, 1000Ljubljana, Slovenia
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Dunlap PM, Khoja SS, Whitney SL, Freburger JK. Predictors of Physical Therapy Referral Among Persons With Peripheral Vestibular Disorders in the United States. Arch Phys Med Rehabil 2020; 101:1747-1753. [PMID: 32445851 DOI: 10.1016/j.apmr.2020.04.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 04/15/2020] [Accepted: 04/19/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To determine the rate of physical therapy (PT) referral and patient and physician characteristics associated with PT referral for benign paroxysmal positional vertigo (BPPV) and other peripheral vestibular disorders (PVD) in ambulatory care clinics in the United States. DESIGN Cross-sectional analysis of the National Ambulatory Medical Care Survey 2004-2015 SETTING: Ambulatory care clinics in the United States. PARTICIPANTS We identified 5.6 million weighted adult visits for BPPV (International Classification of Diseases-9th Revision-Clinical Modifications (ICD-9-CM): 386.11) and 6.6 million weighted visits for other PVDs (ICD-9-CM: 386.1-386.9, excluding 386.11 and 386.2) made by patients 18 years and older from 2004 through 2015. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Patient, clinical, and physician characteristics were extracted, and descriptive statistics were stratified by referral to PT. Two multivariable logistic regression models were estimated for each diagnostic group (BPPV and other PVDs) to identify predictors of PT referral. RESULTS PT referrals for BPPV increased from 6.2% in the period from 2004 to 2006 to 12.9% in the period from 2013 to 2015, whereas PT referrals for other PVDs decreased from 3.8% in the period from 2004 to 2006 to 0.5% in the period from 2013 to 2015. Other insurance coverage (versus private) and neurologists and other specialists (versus otolaryngologists) were associated with a greater odds of PT referral for BPPV. Visits made in the Midwest and West (versus the Northeast) and in rural versus metropolitan areas had greater odds of PT referral for BPPV. Relative to otolaryngologists, primary care physicians were less likely to refer to PT for other PVDs. Visits made in metropolitan versus rural areas and visits with 1 or more comorbidities (versus none) had greater odds of PT referral for other PVDs. CONCLUSIONS PT referrals remain low for ambulatory care visits for BPPV and other PVDs in the United States. Referral to PT for BPPV and other PVDs varied by insurance type, physician specialty, and office location.
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Affiliation(s)
- Pamela M Dunlap
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA.
| | - Samannaaz S Khoja
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA
| | - Susan L Whitney
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA; Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA
| | - Janet K Freburger
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA
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Barbier J, Cudennec T. [Persistent dizziness syndrome]. SOINS. GERONTOLOGIE 2020; 25:47-48. [PMID: 32444084 DOI: 10.1016/j.sger.2020.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Jules Barbier
- Groupe hospitalo-universitaire AP-HP, université Paris-Saclay, site Ambroise-Paré, 9 avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France
| | - Tristan Cudennec
- Groupe hospitalo-universitaire AP-HP, université Paris-Saclay, site Ambroise-Paré, 9 avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France.
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Kovacs E, Wang X, Grill E. Economic burden of vertigo: a systematic review. HEALTH ECONOMICS REVIEW 2019; 9:37. [PMID: 31883042 PMCID: PMC6933936 DOI: 10.1186/s13561-019-0258-2] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 12/10/2019] [Indexed: 05/13/2023]
Abstract
BACKGROUND Vertigo, a highly prevalent disease, imposes a rising burden on the health care system, exacerbated by the ageing of the population; and further, contributes to a wide span of indirect burden due to reduced capacity to work or need of assistance in activities of daily living. The aim of this review was to summarise the evidence on the economic burden of vertigo. METHODS All original studies published between 2008 and 2018 about the economic evaluation of peripheral or central vestibular vertigo in developed countries were considered eligible, unrestricted to setting, health care provider, or study type. RESULTS The electronic search in three databases identified 154 studies from which 16 qualified for inclusion. All studies presented partial economic evaluation referring to a variety of vestibular vertigo including unspecified vertigo. Nine studies presented monetised cost results and seven studies reported health care utilization. Direct costs derived mainly from repeated and not well-targeted consultations at all levels of health care, excessive use of diagnostic imaging, and/or of emergency care. Considerable societal burden was caused by decreased productivity, mainly due to work absenteeism. CONCLUSION To the best of our knowledge, this is the first systematic review of the existing evidence of the economic burden of vertigo. The lack of conclusive evidence revealed apparent targets of future research. First, studies of diagnostics and therapies for vestibular disease should include cost-effectiveness considerations. Population-based studies of health services utilization should include simple vestibular assessments to get more reliable estimates of the burden of disease and associated costs on the level of the general population. Further, clinical and population-based registries that include patients with vestibular disease, should consider collecting long-term data of societal burden. Primary data collection should increasingly include assessment of health care utilization e.g. by linking their diagnoses and outcomes to routine data from health insurances.
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Affiliation(s)
- Eva Kovacs
- Institute for Medical Information Processing, Biometrics and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany.
- German Center for Vertigo and Balance Disorders, Faculty of Medicine, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, Munich, Germany.
| | - Xiaoting Wang
- Institute for Medical Information Processing, Biometrics and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Eva Grill
- Institute for Medical Information Processing, Biometrics and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany
- German Center for Vertigo and Balance Disorders, Faculty of Medicine, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, Munich, Germany
- Munich Center of Health Sciences, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, Munich, Germany
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Fall-risk-increasing adverse reactions-is there value in easily accessible drug information? A case-control study. Eur J Clin Pharmacol 2019; 75:849-857. [PMID: 30758518 DOI: 10.1007/s00228-019-02628-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 01/03/2019] [Indexed: 01/04/2023]
Abstract
PURPOSE The individual fall risk of a patient is often multifactorial. Polymedication contributes to an additional risk of fall-risk-increasing adverse reactions (FRIARs). Previous studies have not sufficiently investigated the complexity facing prescribers when balancing the therapeutic benefits of individual drugs against their potential fall risk. METHODS An expert panel identified drugs with FRIARs based on the Summary of Product Characteristics (SmPC). These FRIARs and other parameters (such as the total number of drugs, dosage, dose adjustments, and drug changes) were then analyzed for their impact on falls in a case-control study using logistic regression. RESULTS During a 1-year period, 112 (1%) of 11,481 hospital patients experienced at least one fall event. Complete data was available for evaluation from 87 of them (case group). We matched these patients to another 87 patients who had no fall events (control group). FRIAR drugs were more frequently prescribed in the case group (4.26 (Q25-Q75, 3.75-4.78) per patient; p = 0.033) than in the control group (3.48 (2.97-3.99)). Drugs with FRIARs (β = 0.137; p = 0.035) and the total number of FRIARs (β = 0.033; p = 0.031) increased the fall risk. The total number of drugs, dosage, dose adjustments, and drug changes showed no influence. CONCLUSIONS FRIARs were associated with a higher number of falls. To consider FRIARs offers a chance to address the complexity of the individual medication. This data can support future computerized physician order entries with clinical decision support.
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Ciorba A, Cogliandolo C, Bianchini C, Aimoni C, Pelucchi S, Skarżyński PH, Hatzopoulos S. Clinical features of benign paroxysmal positional vertigo of the posterior semicircular canal. SAGE Open Med 2019; 7:2050312118822922. [PMID: 30637105 PMCID: PMC6317147 DOI: 10.1177/2050312118822922] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 12/10/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the relationship between age, gender and affected ear, in patients presenting benign paroxysmal positional vertigo. METHODS This was a retrospective study. Data from benign paroxysmal positional vertigo clinical reports (January 2009-December 2014) were analysed. A total of 174 patients affected by benign paroxysmal positional vertigo of the posterior semicircular canal have been identified. Pearson chi-square test has been used to evaluate the probability of benign paroxysmal positional vertigo occurrence in relation to gender and side, within the studied groups. The level of significance was set at a p < 0.05. RESULTS Considering age as a discriminant factor, three groups of patients were identified: group 1: 16 patients with an age <40 years; group 2: 79 patients with an age between 40 and 65 years and group 3: 79 patients with an age >65 years. In each group, the right posterior semicircular canal was involved in the majority of cases (group 1 incidence: 12/16; group 2 incidence: 49/79 and group 3 incidence: 52/79). In all three groups, female patients were significantly more affected (9/16 in group 1, 61/79 in group 2 and 55/79 in group 3). CONCLUSION Benign paroxysmal positional vertigo is most prevalent in female subjects having an age>40 years and mainly involves the right posterior semicircular canal.
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Affiliation(s)
- Andrea Ciorba
- Audiology and ENT Clinic, University of Ferrara, Ferrara, Italy
| | | | | | - Claudia Aimoni
- Audiology and ENT Clinic, University of Ferrara, Ferrara, Italy
| | | | - Piotr Henryk Skarżyński
- Institute of Physiology and Pathology of Hearing, Warsaw, Poland
- Department of Heart Failure and Cardiac Rehabilitation, Medical University of Warsaw, Warsaw, Poland
- Institute of Sensory Organs, Kajetany, Poland
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Silva EMTD, Barbosa ALDA, Mantello EB, Azoni CAS, Gazzola JM. Relationship between dizziness and learning difficulties in schoolchildren: an integrative review. REVISTA CEFAC 2019. [DOI: 10.1590/1982-0216/20192117518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Purpose: this study aims to verify the level of scientific evidence on the relationship between dizziness and academic achievement in childhood. Methods: the study was performed using the following search terms: dizziness, vertigo, child, learning, spelling, learning skills, academic skills, reading, and their correspondents in Portuguese in the following databases: PubMed, Scielo, LILACS and PsycINFO. Observational studies that examined the relationship between dizziness and academic achievement in childhood, published between 2007 and 2017, were included. Articles that did not allow access to the full text, and studies based on samples with motor, hearing, and cognitive disorders were excluded. Results: we initially found 315 articles and three met the established inclusion and exclusion criteria. These were scored according to the Newcastle-Ottawa Modified Scale with scores between 2 and 3 and as IIb according to the American Speech-Language Hearing Association levels of evidence and quality indicators. Conclusion: the results of this integrative review showed a low level of scientific evidence on the relationship between dizziness and academic achievement in childhood. It is important to emphasize the importance of improving study design to better understand their relationship, to allow provision of the best preventive, assessment, and intervention methods.
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Armstrong D, Alderson AJ, Davey CJ, Elliott DB. Development and Validation of the Vision-Related Dizziness Questionnaire. Front Neurol 2018; 9:379. [PMID: 29910767 PMCID: PMC5992411 DOI: 10.3389/fneur.2018.00379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 05/09/2018] [Indexed: 11/13/2022] Open
Abstract
Purpose To develop and validate the first patient-reported outcome measure (PROM) to quantify vision-related dizziness. Dizziness is a common, multifactorial syndrome that causes reductions in quality of life and is a major risk factor for falls, but the role of vision is not well understood. Methods Potential domains and items were identified by literature review and discussions with experts and patients to form a pilot PROM, which was completed by 335 patients with dizziness. Rasch analysis was used to determine the items with good psychometric properties to include in a final PROM, to check undimensionality, differential item functioning, and to convert ordinal questionnaire data into continuous interval data. Validation of the final 25-item instrument was determined by its convergent validity, patient, and item-separation reliability and unidimensionality using data from 223 patients plus test–retest repeatability from 79 patients. Results 120 items were originally identified, then subsequently reduced to 46 to form a pilot PROM. Rasch analysis was used to reduce the number of items to 25 to produce the vision-related dizziness or VRD-25. Two subscales of VRD-12-frequency and VRD-13-severity were shown to be unidimensional, with good psychometric properties. Convergent validity was shown by moderately good correlations with the Dizziness Handicap Inventory (r = 0.75) and good test–retest repeatability with intra-class correlation coefficients of 0.88. Conclusion VRD-25 is the only PROM developed to date to assess vision-related dizziness. It has been developed using Rasch analysis and provides a PROM for this under-researched area and for clinical trials of interventions to reduce vision-related dizziness.
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Affiliation(s)
- Deborah Armstrong
- School of Optometry and Vision Science, University of Bradford, Bradford, United Kingdom
| | - Alison J Alderson
- School of Optometry and Vision Science, University of Bradford, Bradford, United Kingdom
| | - Christopher J Davey
- School of Optometry and Vision Science, University of Bradford, Bradford, United Kingdom
| | - David B Elliott
- School of Optometry and Vision Science, University of Bradford, Bradford, United Kingdom
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Silva AL, Ferreira LMDBM, Freitas RVDM, Lima KCD, Guerra RO, Ribeiro KMOBDF. Quality of life in the institutionalized elderly with dizziness complaint: a cross-sectional study. REVISTA CEFAC 2018. [DOI: 10.1590/1982-021620182023017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Purpose: to evaluate the quality of life in institutionalized elderly people with dizziness complaint and to relate the results to the characteristics of dizziness and functional capacity. Methods: in this cross-sectional study, one-hundred and nineteen elderly residents in three geriatric long-term care institutions in Natal city, Brazil, were evaluated. Those who had presented dizziness in the former year (30/25.2%) were included in this study. The quality of life was measured by the Dizziness Handicap Inventory. Functional capacity was measured by the Berg Balance Scale, the Functional Reach Test, the Unipedal Stance Test with eyes open and closed, and the Falls Efficacy Scale - International. Results: associations were found between physical, functional and emotional aspects and the duration of dizziness (p=0.002, p=0.041 and p=0.004, respectively); the functional aspects with age (p=0.031), the physical aspects with the presence of falls in the previous year (p=0.039); and the physical, functional and emotional aspects of the Dizziness Handicap Inventory with fear of falling (p=0.004, p<0.001 and p=0.016, respectively). Conclusion: institutionalized elderly with dizziness complaints had a low perception of quality of life, and the duration of dizziness, age, falls and fear of falling negatively influenced their quality of life.
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Teggi R, Trimarchi M, Gatti O, Fornasari F, Bussi M. Decrease of Horizontal Canal Vestibulo-Oculomotor Reflex Gain in the Elderly with Dysequilibrium without Lifetime Vertigo. ORL J Otorhinolaryngol Relat Spec 2017; 79:178-184. [PMID: 28486231 DOI: 10.1159/000473894] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 03/29/2017] [Indexed: 01/05/2023]
Abstract
BACKGROUND/AIMS Unsteadiness in the elderly is a frequent complaint and a strong predictor of falls and psychological distress. Although there is a general consensus that it is a multifactorial condition, recent studies have focused on the role of aging of the vestibular system as a possible cofactor. The aim of our work was to assess horizontal canal function in the elderly. METHODS We evaluated the gain of horizontal vestibulo-ocular reflex (VOR) with a video head impulse test on a sample of 58 subjects aged >70 years without lifetime episodes of vertigo and correlated the value with different clinical conditions (hypertension, diabetes, prior cardiovascular and vascular disorders of the central nervous system, and falls). RESULTS The mean value of the gain was 0.86 ± 0.12, and people aged between 70 and 80 years presented higher values (0.90 ± 0.1) compared to those >80 years (0.81 ± 0.13; p = 0.025). Previous vascular disorders of the central nervous system were a predictor of decreased VOR gain (p = 0.0003). A nonparametric analysis demonstrated that sex, age, and VOR gain (p ˂ 0.0001) were predictive of falls. CONCLUSIONS Our data support the hypothesis of a decrease of VOR gain in the elderly. The decrease of canal function may therefore play a role in the risk of falls in the elderly.
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Affiliation(s)
- Roberto Teggi
- ENT Department, San Raffaele Scientific Hospital, Milan, Italy
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