Impact of Balance and Dizziness Problems on Falls in Older Adults: The Longitudinal AGES-Reykjavik Study.

OBJECTIVE

To investigate the impact of balance and dizziness problems (BDP) and other risk factors on falls in a longitudinal, population-based cohort of older adults.

METHODS

The Age, Gene/Environment Susceptibility-Reykjavik Study (AGES-RS I) 2002-2006 examined 5764 adults aged 66-98. Five years later, 3316 surviving subjects were reexamined in AGES-RS II. Participants were asked about BDP, falls, usual activities, and health conditions. BDP symptoms during the past 12 months included: vertigo (spinning/moving sensation); floating/spacey sensation; light-headedness (no moving sensation); near fainting (presyncope) or fainting (syncope); blurred vision with head movement (oscillopsia); and feeling off-balance/unsteady. Clinical assessments included hand grip and leg strength plus steps and time to walk 6 m.

RESULTS

During the past 12 months in AGES-RS II, BDP prevalence was 40.1% (males 35.2%, females 43.7%) and the prevalence of falling was 23.0% (males 20.9%, females 24.8%). BDP increased steps and time to walk 6 m. BDP increased the risk of falls (adjusted prevalence ratio [PR] = 1.53; 95% confidence interval [CI]: 1.34-1.76 for AGES-RS I, PR = 1.77, 95% CI: 1.55-2.03 for AGES-RS II). The prevalence of ≥ 2 falls was 8.9% (15.6% with BDP vs. 4.4% without BDP). Among those who fell ≥ 2 times, 70.4% reported BDP in the past 12 months. Additional risk of falling was associated with fear/panic attacks, memory loss, hearing loss, and other health conditions.

CONCLUSION

BDP are common in older adults and associated with 50% to 80% increased risk of falling and even greater risk of falling ≥ 2 times. Quantitative estimates are provided for contributing factors that further increase the risk of falls.

LEVEL OF EVIDENCE: 2 (prospective cohort study).