Impact of chronic dizziness or imbalance on falling and performance on a Romberg Test of Standing Balance in U.S. adults

Background: Few population-based studies have assessed balance problems and symptoms of chronic dizziness or imbalance. Understanding the epidemiology of balance/vestibular disorders is a high priority for developing health screenings and interventions.

Methods: Interviews and a modified Romberg Test of Standing Balance were conducted in the National Health and Nutrition Examination Survey (NHANES), 1999–2004. Problems with dizziness or imbalance and falls were reported in the interview. The Romberg tested standing, feet together, on a firm surface without moving for 15 seconds, with eyes open and then eyes shut; then standing for 30 seconds on a compliant surface (foam pad), with eyes open and then eyes shut. The Romberg was scored pass/fail; failing was inability to complete each of the four conditions after two attempts. About 10% met Romberg exclusion criteria.

Results: Of adults 40+ years, 5.5% (6.7 million) reported chronic (3+ months) imbalance, 3.8% (4.6 million) chronic dizziness and 2.3% (2.8 million) both. 48% of subjects with chronic imbalance fell in the past year and only one-third passed the Romberg. No problem with dizziness or balance was reported by 77.1%. Of these, only 1% reported falling and two-thirds passed the Romberg. Other conditions associated with falling or chronic dizziness or imbalance included cardiovascular disease, stroke, and trouble seeing.

Conclusions: Subjects reporting problems with dizziness and especially balance are at higher risk of falling, based on both recent history of falls and clinical testing. Interventions such as physical therapy may improve balance, reduce risk of falling and improve quality of life.