141st APHA Annual Meeting and Exposition

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279804
Impact of dizziness and balance problems and other chronic health conditions on falling risk in United States adults


Monday, November 4, 2013 : 12:38 p.m. - 12:56 p.m.

Howard J. Hoffman, MA, Epidemiology and Statistics Program, National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health (NIH), Bethesda, MD
Chuan-Ming Li, MD, PhD, Epidemiology and Statistics Program, National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health (NIH), Bethesda, MD
Katalin G. Losonczy, MA, Epidemiology and Statistics Program, National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health (NIH), Bethesda, MD
Daniel A. Sklare, PhD, Hearing and Balance Program, National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health (NIH), Bethesda, MD
Helen Cohen, EdD, OTR, Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, TX
Charley C. Della Santina, PhD, MD, Department of Otolaryngology-Head and Neck Surgery, Vestibular Clinical Testing Laboratory, Johns Hopkins Medicine, The Johns Hopkins University, Baltimore, MD
Background: The 2008 National Health Interview Survey (NHIS) Balance and Dizziness Supplement is the first household survey of United States civilian, non-institutionalized adults (ages 18+) to include extensive coverage of disturbances in balance and vestibular function.

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=1.80–2.29), females (OR=1.79, CI=1.62–1.96), non-Hispanic whites (OR=1.43, CI=1.28–1.61), and family incomes below $35,000 (OR=1.63, CI=1.43–1.86). 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=1.58–13.90), stroke (OR=3.26, CI=1.90–5.60), depression (OR=2.18, CI=1.38–3.44), vision problems (OR=2.15, CI=1.31–3.52), epilepsy/seizures (OR=2.04, CI=0.99–4.18), diabetes (OR=1.89, CI=1.06–3.39), and head/brain injury (OR=1.87, CI=1.12–13.90). 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
Epidemiology
Planning of health education strategies, interventions, and programs
Provision of health care to the public

Learning Objectives:
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

Presenting author's disclosure statement:

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.

Back to: 3239.0: Epidemiology of Aging