Advertisement

Quality of Life Research

, Volume 23, Issue 8, pp 2301–2308 | Cite as

Impact of vertigo and dizziness on self-perceived participation and autonomy in older adults: results from the KORA-Age study

  • Martin MuellerEmail author
  • Ralf Strobl
  • Klaus Jahn
  • Birgit Linkohr
  • Karl Heinz Ladwig
  • Andreas Mielck
  • Eva Grill
Article

Abstract

Purpose

The impact of vertigo and dizziness on healthy ageing, and especially on participation, is not fully understood. The objective of this study was to investigate the association of vertigo and dizziness with self-perceived participation and autonomy in older non-institutionalised individuals, adjusted for the presence of other health conditions. Specifically, we wanted to investigate the different effects of vertigo and dizziness on specific components of participation, i.e. restrictions in indoor and outdoor autonomy, family role, social life and relationships, and work and education.

Methods

Data originate from the second wave of the German KORA-Age cohort study collected in 2012. Participation and autonomy was investigated with the Impact on Participation and Autonomy Questionnaire. We used robust regression to analyse the association of vertigo and dizziness with self-perceived participation and autonomy adjusted for covariates.

Results

A total of 822 participants (49.6 % female) had a mean age of 78.1 years (SD 6.39). Participation and autonomy were significantly lower in participants with vertigo and dizziness across all domains. Adjusted for age, sex, and chronic conditions, vertigo and dizziness were significantly associated with participation restrictions in all domains except social life and relationships.

Conclusion

The results of our study indicate that vertigo and dizziness contribute to restrictions in participation and autonomy in individuals of older age. Recognising vertigo and dizziness as independent contributors to loss of autonomy and decreased chances for independent living may create new options for patient care and population health, such as the designing of complex interventions to maintain participation and autonomy.

Keywords

Aged Aged, 80 and over Participation Autonomy Chronic conditions Vertigo Dizziness 

Notes

Acknowledgments

The KORA research platform (KORA, Cooperative Research in the Region of Augsburg) was initiated and financed by the Helmholtz Zentrum München—German Research Center for Environmental Health, which is funded by the German Federal Ministry of Education and Research and by the state of Bavaria. The KORA-Age project was financed by the German Federal Ministry of Education and Research (BMBF FKZ 01ET0713, 01ET1003AIFB, 01ET1003A, and 01ET1003C). This project was also supported by funds from the German Federal Ministry of Education and Research under the Grant Code 01 EO 0901. The authors bear full responsibility for the content of this publication. We thank the team at the KORA study centre in Augsburg who carried out the field work for this study and the team at the Helmholtz Zentrum München for maintaining these complex data.

References

  1. 1.
    Agrawal, Y., Carey, J. P., Della Santina, C. C., Schubert, M. C., & Minor, L. B. (2009). Disorders of balance and vestibular function in US adults: Data from the national health and nutrition examination survey, 2001–2004. Archives of Internal Medicine, 169(10), 938–944.PubMedCrossRefGoogle Scholar
  2. 2.
    Lin, H. W., & Bhattacharyya, N. (2012). Balance disorders in the elderly: Epidemiology and functional impact. Laryngoscope, 122(8), 1858–1861.PubMedCrossRefGoogle Scholar
  3. 3.
    Neuhauser, H., Radtke, A., von Brevern, M., Lezius, F., Feldmann, M., & Lempert, T. (2008). Burden of dizziness and vertigo in the community. Archives of Internal Medicine, 168(19), 2118–2124.PubMedCrossRefGoogle Scholar
  4. 4.
    de Moraes, S. A., Soares, W. J., Ferriolli, E., & Perracini, M. R. (2013). Prevalence and correlates of dizziness in community-dwelling older people: A cross sectional population based study. BMC Geriatrics, 13(1), 4.PubMedCentralPubMedCrossRefGoogle Scholar
  5. 5.
    Jonsson, R., Sixt, E., Landahl, S., & Rosenhall, U. (2004). Prevalence of dizziness and vertigo in an urban elderly population. Journal of Vestibular Research, 14(1), 47–52.PubMedGoogle Scholar
  6. 6.
    Gomez, F., Curcio, C. L., & Duque, G. (2011). Dizziness as a geriatric condition among rural community-dwelling older adults. Journal of Nutrition, Health, and Aging, 15(6), 490–497.PubMedCrossRefGoogle Scholar
  7. 7.
    Gassmann, K. G., Rupprecht, R., & Group IZGS. (2009). Dizziness in an older community dwelling population: A multifactorial syndrome. Journal of Nutrition, Health, and Aging, 13(3), 278–282.PubMedCrossRefGoogle Scholar
  8. 8.
    Maarsingh, O. R., Dros, J., Schellevis, F. G., van Weert, H. C., van der Windt, D. A., ter Riet, G., et al. (2010). Causes of persistent dizziness in elderly patients in primary care. The Annals of Family Medicine, 8(3), 196–205.CrossRefGoogle Scholar
  9. 9.
    Sloane, P., Blazer, D., & George, L. K. (1989). Dizziness in a community elderly population. Journal of the American Geriatrics Society, 37(2), 101–108.PubMedGoogle Scholar
  10. 10.
    Kruschinski, C., Sczepanek, J., Wiese, B., Breull, A., Junius-Walker, U., & Hummers-Pradier, E. (2011). A three-group comparison of acute-onset dizzy, long-term dizzy and non-dizzy older patients in primary care. Aging Clinical and Experimental Research, 23(4), 288–295.PubMedCrossRefGoogle Scholar
  11. 11.
    Radtke, A., Lempert, T., von Brevern, M., Feldmann, M., Lezius, F., & Neuhauser, H. (2011). Prevalence and complications of orthostatic dizziness in the general population. Clinical Autonomic Research, 21(3), 161–168.PubMedCrossRefGoogle Scholar
  12. 12.
    Kristinsdottir, E. K., Jarnlo, G. B., & Magnusson, M. (1997). Aberrations in postural control, vibration sensation and some vestibular findings in healthy 64-92-year-old subjects. Scandinavian Journal of Rehabilitation Medicine, 29(4), 257–265.PubMedGoogle Scholar
  13. 13.
    Tinetti, M. E., Williams, C. S., & Gill, T. M. (2000). Dizziness among older adults: A possible geriatric syndrome. Annals of Internal Medicine, 132(5), 337–344.PubMedCrossRefGoogle Scholar
  14. 14.
    Hauer, K. A., Kempen, G. I., Schwenk, M., Yardley, L., Beyer, N., Todd, C., et al. (2011). Validity and sensitivity to change of the falls efficacy scales international to assess fear of falling in older adults with and without cognitive impairment. Gerontology, 57(5), 462–472.PubMedGoogle Scholar
  15. 15.
    Rowe, J. W., & Kahn, R. L. (1997). Successful aging. Gerontologist, 37(4), 433–440.PubMedCrossRefGoogle Scholar
  16. 16.
    World Health Organisation. (2001). International classification of functioning, disability and health: ICF. Geneva: WHO.Google Scholar
  17. 17.
    Alghwiri, A., Alghadir, A., & Whitney, S. L. (2013). The vestibular activities and participation measure and vestibular disorders. Journal of Vestibular Research, 23(6), 305–312.PubMedGoogle Scholar
  18. 18.
    Alghwiri, A. A., Whitney, S. L., Baker, C. E., Sparto, P. J., Marchetti, G. F., Rogers, J. C., et al. (2012). The development and validation of the vestibular activities and participation measure. Archives of Physical Medicine and Rehabilitation, 93(10), 1822–1831.PubMedCrossRefGoogle Scholar
  19. 19.
    Holle, R., Happich, M., Lowel, H., & Wichmann, H. E. (2005). KORA: A research platform for population based health research. Gesundheitswesen, 67(Suppl 1), S19–S25.PubMedCrossRefGoogle Scholar
  20. 20.
    Peters, A., Doring, A., Ladwig, K. H., Meisinger, C., Linkohr, B., Autenrieth, C., et al. (2011). Multimorbidity and successful aging: The population-based KORA-Age study. Zeitschrift fur Gerontologie und Geriatrie, 44(Suppl 2), 41–54.PubMedCrossRefGoogle Scholar
  21. 21.
    Cardol, M., de Haan, R. J., van den Bos, G. A., de Jong, B. A., & de Groot, I. J. (1999). The development of a handicap assessment questionnaire: The impact on participation and autonomy (IPA). Clinical Rehabilitation, 13(5), 411–419.PubMedCrossRefGoogle Scholar
  22. 22.
    Noonan, V. K., Kopec, J. A., Noreau, L., Singer, J., Chan, A., Masse, L. C., et al. (2009). Comparing the content of participation instruments using the international classification of functioning, disability and health. Health Qual Life Outcomes, 7, 93.PubMedCentralPubMedCrossRefGoogle Scholar
  23. 23.
    Noonan, V. K., Kopec, J. A., Noreau, L., Singer, J., & Dvorak, M. F. (2009). A review of participation instruments based on the international classification of functioning, disability and health. Disability and Rehabilitation, 31(23), 1883–1901.PubMedCrossRefGoogle Scholar
  24. 24.
    Mueller, M., Strobl, R., Jahn, K., Linkohr, B., Peters, A., & Grill, E. (2013). Burden of disability attributable to vertigo and dizziness in the aged: Results from the KORA-Age study. The European Journal of Public Health. doi: 10.1093/eurpub/ckt171
  25. 25.
    Kirchberger, I., Meisinger, C., Heier, M., Zimmermann, A.-K., Thorand, B., Autenrieth, C. S., et al. (2012). Patterns of multimorbidity in the aged population. results from the KORA-Age Study. PLoS ONE, 7(1), e30556.PubMedCentralPubMedCrossRefGoogle Scholar
  26. 26.
    Sheikh, J. I., & Yesavage, J. A. (1985). A knowledge assessment test for geriatric psychiatry. Hospital and Community Psychiatry, 36(11), 1160–1166.PubMedGoogle Scholar
  27. 27.
    Spitzer, R. L., Kroenke, K., Williams, J. B., & Lowe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097.PubMedCrossRefGoogle Scholar
  28. 28.
    Wildner, M., Doring, A., Meisinger, C., & Clark, D. E. (2005). Fractures in the elderly: A challenge for prevention and health promotion-results from the KORA fracture study Augsburg. Gesundheitswesen, 67(Suppl 1), S180–S186.PubMedCrossRefGoogle Scholar
  29. 29.
    Wilcoxon, F. (1945). Individual comparisons by ranking methods. Biometrics Bulletin, 1(6), 80–83.CrossRefGoogle Scholar
  30. 30.
    Huber, P. J. (1964). Robust estimation of a location parameter. Annals of Mathematical Statistics, 35, 73–101.CrossRefGoogle Scholar
  31. 31.
    Ernst, M. (2004). Permutation methods: A basis for exact inference. Statistical Science, 19(4), 676–685.CrossRefGoogle Scholar
  32. 32.
    Fisher, R. (1935). The design of experiments. Edinburgh, UK: Oliver and Boyd.Google Scholar
  33. 33.
    R Core Team. (2012). A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing.Google Scholar
  34. 34.
    Cohen, H. S., Mulavara, A. P., Peters, B. T., Sangi-Haghpeykar, H., & Bloomberg, J. J. (2012). Tests of walking balance for screening vestibular disorders. Journal of Vestibular Research, 22(2), 95–104.PubMedCentralPubMedGoogle Scholar
  35. 35.
    Bronstein, A. M., & Lempert, T. (2010). Management of the patient with chronic dizziness. Restorative Neurology and Neuroscience, 28(1), 83–90.PubMedGoogle Scholar
  36. 36.
    Gassmann, K. G., Rupprecht, R., Freiberger, E., & Group IZGS. (2009). Predictors for occasional and recurrent falls in community-dwelling older people. Zeitschrift für Gerontologie und Geriatrie, 42(1), 3–10.PubMedCrossRefGoogle Scholar
  37. 37.
    Jorstad, E. C., Hauer, K., Becker, C., Lamb, S. E., & ProFa, N. E. G. (2005). Measuring the psychological outcomes of falling: A systematic review. Journal of the American Geriatrics Society, 53(3), 501–510.PubMedCrossRefGoogle Scholar
  38. 38.
    Aratani, M. C., Perracini, M. R., Caovilla, H. H., Gazzola, J. M., Gananca, M. M., & Gananca, F. F. (2011). Disability rank in vestibular older adults. Geriatrics and Gerontology International, 11(1), 50–54.PubMedCrossRefGoogle Scholar
  39. 39.
    Hong, S. M., Lee, H. J., Lee, B., Park, S. K., Hong, S. K., Park, I. S., et al. (2013). Influence of vestibular disease on psychological distress: A multicenter study. Otolaryngology: Head and Neck Surgery, 148(5), 810–814.Google Scholar
  40. 40.
    Bronstein, A. M., Golding, J. F., Gresty, M. A., Mandala, M., Nuti, D., Shetye, A., et al. (2010). The social impact of dizziness in London and Siena. Journal of Neurology, 257(2), 183–190.PubMedCrossRefGoogle Scholar
  41. 41.
    Dros, J., Maarsingh, O. R., Beem, L., van der Horst, H. E., ter Riet, G., Schellevis, F. G., et al. (2011). Impact of dizziness on everyday life in older primary care patients: A cross-sectional study. Health Qual Life Outcomes, 9, 44.PubMedCentralPubMedCrossRefGoogle Scholar
  42. 42.
    Meisinger, C., Wildner, M., Doring, A., & Sangha, O. (2000). Validity and reliability of proband recall of fractures. Sozial- und Praventivmedizin, 45(5), 203–207.PubMedCrossRefGoogle Scholar
  43. 43.
    Holle, R., Hochadel, M., Reitmeir, P., Meisinger, C., Wichmann, H. E., & Group K. (2006). Prolonged recruitment efforts in health surveys: Effects on response, costs, and potential bias. Epidemiology, 17(6), 639–643.PubMedCrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Martin Mueller
    • 1
    • 2
    Email author
  • Ralf Strobl
    • 1
    • 2
  • Klaus Jahn
    • 2
    • 3
  • Birgit Linkohr
    • 4
  • Karl Heinz Ladwig
    • 4
  • Andreas Mielck
    • 5
  • Eva Grill
    • 1
    • 2
  1. 1.Institute for Medical Information Processing, Biometrics and EpidemiologyLudwig-Maximilians-Universität MünchenMunichGermany
  2. 2.German Center for Vertigo and Balance DisordersLudwig-Maximilians-Universität MünchenMunichGermany
  3. 3.Department of NeurologyLudwig-Maximilians-Universität MünchenMunichGermany
  4. 4.Institute of Epidemiology IIHelmholtz Zentrum MünchenNeuherbergGermany
  5. 5.Institute of Health Economics and Health Care ManagementHelmholtz Zentrum MünchenNeuherbergGermany

Personalised recommendations