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      Prevalence and correlates of dizziness in community-dwelling older people: a cross sectional population based study

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          Abstract

          Background

          Dizziness is a common complaint among older adults and has been linked to a wide range of health conditions, psychological and social characteristics in this population. However a profile of dizziness is still uncertain which hampers clinical decision-making. We therefore sought to explore the relationship between dizziness and a comprehensive range of demographic data, diseases, health and geriatric conditions, and geriatric syndromes in a representative sample of community-dwelling older people.

          Methods

          This is a cross-sectional, population-based study derived from FIBRA (Network for the Study of Frailty in Brazilian Elderly Adults), with 391 elderly adults, both men and women, aged 65 years and older. Elderly participants living at home in an urban area were enrolled through a process of random cluster sampling of census regions. The outcome variable was the self-report of dizziness in the last year. Several feelings of dizziness were investigated including vertigo, spinning, light or heavy headedness, floating, fuzziness, giddiness and instability. A multivariate logistic regression analysis was conducted to estimate the adjusted odds ratios and build the probability model for dizziness.

          Results

          The complaint of dizziness was reported by 45% of elderly adults, from which 71.6% were women ( p=0.004). The multivariate regression analysis revealed that dizziness is associated with depressive symptoms (OR = 2.08; 95% CI 1.29–3.35), perceived fatigue (OR = 1.93; 95% CI 1.21-3.10), recurring falls (OR = 2.01; 95% CI 1.11-3.62) and excessive drowsiness (OR = 1.91; 95% CI 1.11–3.29). The discrimination of the final model was AUC = 0.673 (95% CI 0.619-0.727) (p< 0.001).

          Conclusions

          The prevalence of dizziness in community-dwelling elderly adults is substantial. It is associated with other common geriatric conditions usually neglected in elderly adults, such as fatigue and drowsiness, supporting its possible multifactorial manifestation. Our findings demonstrate the need to expand the design in future studies, aiming to estimate risk and identify possible causal relations.

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          Most cited references33

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          A questionnaire for the assessment of leisure time physical activities.

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            Daytime sleepiness, snoring, and obstructive sleep apnea. The Epworth Sleepiness Scale.

            W. Johns (1992)
            The Epworth Sleepiness Scale (ESS) is a simple questionnaire measuring the general level of daytime sleepiness, called here the average sleep propensity. This is a measure of the probability of falling asleep in a variety of situations. The conceptual basis of the ESS involves a four-process model of sleep and wakefulness. The sleep propensity at any particular time is a function of the ratio of the total sleep drive to the total wake drive with which it competes. ESS scores significantly distinguished patients with primary snoring from those with obstructive sleep apnea syndrome (OSAS), and ESS scores increased with the severity of OSAS. Multiple regression analysis showed that ESS scores were more closely related to the frequency of apneas than to the degree of hypoxemia in OSAS. ESS scores give a useful measure of average sleep propensity, comparable to the results of all-day tests such as the multiple sleep latency test.
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              Geriatric conditions and disability: the Health and Retirement Study.

              Geriatric conditions, such as incontinence and falling, are not part of the traditional disease model of medicine and may be overlooked in the care of older adults. The prevalence of geriatric conditions and their effect on health and disability in older adults has not been investigated in population-based samples. To investigate the prevalence of geriatric conditions and their association with dependency in activities of daily living by using nationally representative data. Cross-sectional analysis. Health and Retirement Study survey administered in 2000. Adults age 65 years or older (n = 11 093, representing 34.5 million older Americans) living in the community and in nursing homes. Geriatric conditions (cognitive impairment, falls, incontinence, low body mass index, dizziness, vision impairment, hearing impairment) and dependency in activities of daily living (bathing, dressing, eating, transferring, toileting). Of adults age 65 years or older, 49.9% had 1 or more geriatric conditions. Some conditions were as prevalent as common chronic diseases, such as heart disease and diabetes. The association between geriatric conditions and dependency in activities of daily living was strong and significant, even after adjustment for demographic characteristics and chronic diseases (adjusted risk ratio, 2.1 [95% CI, 1.9 to 2.4] for 1 geriatric condition, 3.6 [CI, 3.1 to 4.1] for 2 conditions, and 6.6 [CI, 5.6 to 7.6] for > or =3 conditions). The study was cross-sectional and based on self-reported data. Because measures were limited by the survey questions, important conditions, such as delirium and frailty, were not assessed. Survival biases may influence the estimates. Geriatric conditions are similar in prevalence to chronic diseases in older adults and in some cases are as strongly associated with disability. The findings suggest that geriatric conditions, although not a target of current models of health care, are important to the health and function of older adults and should be addressed in their care.
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                Author and article information

                Contributors
                Journal
                BMC Geriatr
                BMC Geriatr
                BMC Geriatrics
                BioMed Central
                1471-2318
                2013
                4 January 2013
                : 13
                : 4
                Affiliations
                [1 ]Physical Therapy Department, City of Sao Paulo University, Sao Paulo, Brazil
                [2 ]Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil
                [3 ]Faculty of Medicine, State University of Campinas, Sao Paulo, Brazil
                [4 ]Visiting Research Fellow at Sydney University and The George Institute for Global Health, Sydney, Australia
                Article
                1471-2318-13-4
                10.1186/1471-2318-13-4
                3545826
                23290128
                a210f53d-491a-4371-8d04-057739819e39
                Copyright ©2013 Moraes et al.; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 4 July 2012
                : 6 December 2012
                Categories
                Research Article

                Geriatric medicine
                aged,depression,dizziness,elderly adults,fatigue,sleep disorders by excessive drowsiness,cross sectional study

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