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Benign Paroxysmal Positional Vertigo is a common cause of dizziness and unsteadiness in a large population of 75-year-olds
Örebro University, School of Health and Medical Sciences.
Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
Örebro University, School of Health and Medical Sciences.ORCID iD: 0000-0003-2411-1795
Örebro University, School of Health and Medical Sciences.
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(English)Manuscript (preprint) (Other academic)
Abstract [en]

Background and aims: Dizziness is a common problem among the elderly. Studies have shown that 65% of people with dizziness may have a vestibular etiologic diagnosis, possibly Benign Paroxysmal Positional Vertigo (BPPV). The diagnosis of BPPV is made by history and findings in the Dix-Hallpike test. It can be difficult to perform the Dix-Hallpike test in elderly persons due to limited range of motion when extending the neck. In this study we used a side-lying test to stimulate the posterior semicircular canal while the head and neck were fully supported on the examination table. The aims were to investigate the prevalence of dizziness or impaired balance and BPPV in a 75-year old population. Methods: A representative population sample of 675 persons completed a questionnaire about dizziness and 571 persons performed side-lying, static balance and dynamic walking tests.

Results: Subjective dizziness and/or impaired balance was found in 36% especially when walking outdoors. A significant gender difference was found with a higher prevalence in women (40%) compared to men (30%) (p<0.01). BPPV was found in 11%. This was significantly more common in women compared to men (p<0.01). Elderly persons with BPPV also showed significantly impaired balance ability in static and dynamic balance tests compared to age matched persons without BPPV(p<0.01). Persons with BPPV reported significantly more subjective problems with dizziness and balance compared to persons without BPPV (p<0.001).

Conclusions: Subjective and objective unsteadiness, dizziness and BPPV are common in elderly. The side-lying test is a good screening test for BPPV.

Keyword [en]
Benign paroxysmal positional vertigo, Dizziness, Static balance, Dynamic balance, Elderly
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-15463OAI: oai:DiVA.org:oru-15463DiVA, id: diva2:414759
Note

Lena Kollén is also affiliated w. Department of Physiotherapy, Sahlgrenska University, Hospital, Gothenburg Sweden Margareta Möller is also affiliated w. Örebro University Centre for Health CareSciences, Örebro University Hospital, Sweden Claes Möller is also affiliated w. Örebro University Audiological Research Center, Örebro University Hospital, Institute for Disability Research, Sweden Monika Fagervik Olsén is also affiliated w. Department of Physiotherapy, Institute of Neuroscience and Physiology,The Sahlgrenska Academy at Göteborg University, Sweden

Available from: 2011-05-04 Created: 2011-05-04 Last updated: 2017-10-17Bibliographically approved
In thesis
1. Dizziness, balance and rehabilitation in vestibular disorders
Open this publication in new window or tab >>Dizziness, balance and rehabilitation in vestibular disorders
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Dizziness and balance problems are common symptoms at all ages. The aims were; to evaluate rehabilitation, static, dynamic balance and recovery in acute unilateral vestibular loss (AUVL), to evaluate the treatment of benign paroxysmal positional vertigo (BPPV) with assessment of static and dynamic balance and to evaluate the prevalence of dizziness and BPPV in a population of 75-year-olds.

Study 1: Twenty-seven patients (51years) with AUVL were included and the recovery was followed regarding vestibular function, dizziness, and sick-leave. The recovery was rapid, with disappearance of spontaneous nystagmus and rapid return to work.

Study II: Forty two patents (51 years) with AUVL were included and compared with a reference group. Static and dynamic balance were assessed after six months. Significant instability was found both in static and dynamic balance compared to a reference group.

Study III: Seventeen patients (52 years) with severe BPPV (> 3 months) were treated with Semonts´s manouver and/or Brandt-Daroff exercises. The recovery was evaluated by Dix-Hallpike test, subjective dizziness, unsteadiness and balance tests, after 1, 6 and 12 months. Semont´s maneouver resolved dizziness but the long term follow up showed impaired balance.

Study IV: A large cohort (675) of elderly was assessed regarding dizziness and BPPV. Side lying test and balance tests were applied. A high prevalence of dizziness (36%) and BPPV (11%) was found.

Conclusions: Patients with AUVL and BPPV have despite good symptomatic relief, still impaired static and dynamic balance at long term follow up. BPPV in elderly is common and should be examined since it can be treated.

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2011. p. 78
Series
Örebro Studies in Care Sciences, ISSN 1652-1153 ; 33
Keyword
benign paroxysmal positional vertigo, static balance, dynamic balance, unilateral vestibular loss, dizziness, walking, vestibular rehabilitation
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-15012 (URN)978-91-7668-797-0 (ISBN)
Public defence
2011-06-10, Arvid Carlssons föreläsningssal, Sahlgrenska akademin,Göteborgs universitet, Göteborg, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2011-03-17 Created: 2011-03-17 Last updated: 2017-10-17Bibliographically approved

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