Impact of dizziness and balance problems and other chronic health conditions on falling risk in United States adults
Objective: To investigate associations between dizziness/imbalance and chronic health conditions with falling risk during the past year.
Methods: Respondents (N=21,781) were asked about dizziness/imbalance (DI) symptoms, use of balance aids, physical and psychological problems, health care utilization and outcomes. Characteristics of frequent fallers (FF) who reported falling at least once a month were compared to those falling less (FL) often and those that did not fall (NF).
Results: Annual DI symptom prevalence was 14.8% (33.4 million adults); higher for women, 18.3%, than men, 11.1%. DI was associated with ages 65+ (OR=2.03, CI=1.802.29), females (OR=1.79, CI=1.621.96), non-Hispanic whites (OR=1.43, CI=1.281.61), and family incomes below $35,000 (OR=1.63, CI=1.431.86). FF prevalence was 1.3%, FL 10.1%, and NF 88.6%. Respondents with DI accounted for 64.1% of FF; age/sex did not increase falling risk of these subjects. Unsteadiness (28.0%) was the most common bothersome symptom, followed by lightheadedness (18.4%) and fainting (16.3%). FF with DI had increased multivariately-adjusted risks in association with movement disorders (OR=4.68, CI=1.5813.90), stroke (OR=3.26, CI=1.905.60), depression (OR=2.18, CI=1.383.44), vision problems (OR=2.15, CI=1.313.52), epilepsy/seizures (OR=2.04, CI=0.994.18), diabetes (OR=1.89, CI=1.063.39), and head/brain injury (OR=1.87, CI=1.1213.90). Injuries from falling were reported by 46.9%. Half (51.9%) of FF with DI symptoms reported health conditions as reasons for falling.
Conclusions: DI symptoms in combination with chronic health conditions are strongly associated with frequent, injurious falls.
Learning Areas:Chronic disease management and prevention
Clinical medicine applied in public health
Conduct evaluation related to programs, research, and other areas of practice
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Demonstrate the high prevalence among U.S. adults of chronic dizziness and balance problems and the impact these disturbances in balance function have on the risk of falls and injuries related to falls.
Keyword(s): Chronic Illness, Injury Risk
Qualified on the content I am responsible for because: In my 40+ years as a professional epidemiologist and statistician at NIH, I have planned and directed numerous national and foreign research studies in maternal and child health, aging, and neurosensory epidemiology, including many collaborations with other Federal agencies and university-based colleagues. These studies have resulted in over 220 peer reviewed scientific publications in the public health field.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.