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      Dizziness and its association with walking speed and falls efficacy among older men and women in an urban population

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          Abstract

          Background

          Dizziness is common among older people and falling is a feared complication.

          Aim

          The purpose of this study was to investigate the presence of dizziness and its association with falls, walking speed and fear of falling, including sex differences, among 79-year-olds. Secondary purposes were to describe the relationship between dizziness and falls to number of medications and diseases.

          Method

          The study consisted of the fifth cohort of Gothenburg’s H70 birth cohort studies. A sample of 662 79-year-olds (404 women, 258 men) were investigated with questions regarding dizziness, previous falls and falls efficacy [estimated according to the falls efficacy scale Swedish version (FES (S))]. Functional tests included self-selected and maximal walking speed over 20 m.

          Results

          Dizziness was reported among 51% of the women and by 58% of the men ( p = 0.12). Approximately, 40% had fallen during the past 12 months (41% women, 38% of the men, p = 0.48). Dizziness was related to a higher risk of falls among women (OR 2.63 (95% CI 1.67−4.14, p < 0.0001), but not among men (OR 1.07, 95% CI 0.63−1.82, p = 0.8). Dizzy individuals had lower scores on FES (S) ( p < 0.01), more medications ( p < 0.001) and diseases ( p < 0.001) than those without dizziness. Participants who reported dizziness walked 10% slower than participants without dizziness ( p < 0.001).

          Conclusion

          Women with dizziness more often reported falls compared to women without dizziness—a trend that was not seen among men. Persons with dizziness walked slower. Many medications increased risk of falling; hence, number of medications alone might help pinpoint risk groups for falling.

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          Most cited references23

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          Falls efficacy as a measure of fear of falling.

          We developed the Falls Efficacy Scale (FES), an instrument to measure fear of falling, based on the operational definition of this fear as "low perceived self-efficacy at avoiding falls during essential, nonhazardous activities of daily living." The reliability and validity of the FES were assessed in two samples of community-living elderly persons. The FES showed good test-retest reliability (Pearson's correlation 0.71). Subjects who reported avoiding activities because of fear of falling had higher FES scores, representing lower self-efficacy or confidence, than subjects not reporting fear of falling. The independent predictors of FES score were usual walking pace (a measure of physical ability), anxiety, and depression. The FES appears to be a reliable and valid method for measuring fear of falling. This instrument may be useful in assessing the independent contribution of fear of falling to functional decline among elderly people.
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            Epidemiology of benign paroxysmal positional vertigo: a population based study.

            To examine the prevalence and incidence, clinical presentation, societal impact and comorbid conditions of benign paroxysmal positional vertigo (BPPV) in the general population. Cross-sectional, nationally representative neurotological survey of the general adult population in Germany with a two stage sampling design: screening of 4869 participants from the German National Telephone Health Interview Survey 2003 (response rate 52%) for moderate or severe dizziness or vertigo, followed by validated neurotological interviews (n = 1003; response rate 87%). Diagnostic criteria for BPPV were at least five attacks of vestibular vertigo lasting <1 min without concomitant neurological symptoms and invariably provoked by typical changes in head position. In a concurrent validation study (n = 61) conducted in two specialised dizziness clinics, BPPV was detected by our telephone interview with a specificity of 92% and a sensitivity of 88% (positive predictive value 88%, negative predictive value 92%). BPPV accounted for 8% of individuals with moderate or severe dizziness/vertigo. The lifetime prevalence of BPPV was 2.4%, the 1 year prevalence was 1.6% and the 1 year incidence was 0.6%. The median duration of an episode was 2 weeks. In 86% of affected individuals, BPPV led to medical consultation, interruption of daily activities or sick leave. In total, only 8% of affected participants received effective treatment. On multivariate analysis, age, migraine, hypertension, hyperlipidaemia and stroke were independently associated with BPPV. BPPV is a common vestibular disorder leading to significant morbidity, psychosocial impact and medical costs.
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              The prevalence and correlates of fear of falling in elderly persons living in the community.

              Fear of falling has been recognized as a potentially debilitating consequence of falling in elderly persons. However, the prevalence and the correlates of this fear are unknown. Prevalence of fear of falling was calculated from the 1-year follow-up of an age- and gender-stratified random sample of community-dwelling elderly persons. Cross-sectional associations of fear of falling with quality of life, frailty, and falling were assessed. The prevalence of fear increased with age and was greater in women. After adjustment for age and gender, being moderately fearful of falling was associated with decreased satisfaction with life, increased frailty and depressed mood, and recent experience with falls. Being very fearful of falling was associated with all of the above plus decreased mobility and social activities. Fear of falling is common in elderly persons and is associated with decreased quality of life, increased frailty, and recent experience with falls.
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                Author and article information

                Contributors
                ellen.lindell@vgregion.se
                Journal
                Aging Clin Exp Res
                Aging Clin Exp Res
                Aging Clinical and Experimental Research
                Springer International Publishing (Cham )
                1594-0667
                1720-8319
                5 September 2019
                5 September 2019
                2020
                : 32
                : 6
                : 1049-1056
                Affiliations
                [1 ]GRID grid.1649.a, ISNI 000000009445082X, Department of Otorhinolaryngology, Head and Neck Surgery, , Region Västra Götaland, Sahlgrenska University Hospital, ; 413 45 Gothenburg, Sweden
                [2 ]GRID grid.8761.8, ISNI 0000 0000 9919 9582, Institute of Clinical Sciences, Sahlgrenska Academy, , University of Gothenburg, ; Gothenburg, Sweden
                [3 ]GRID grid.1649.a, ISNI 000000009445082X, Department of Occupational Therapy and Physiotherapy, , Region Västra Götaland, Sahlgrenska University Hospital, ; Gothenburg, Sweden
                [4 ]GRID grid.1649.a, ISNI 000000009445082X, Department of Oncology, , Region Västra Götaland, Sahlgrenska University Hospital, ; Gothenburg, Sweden
                [5 ]GRID grid.8761.8, ISNI 0000 0000 9919 9582, Neuropsychiatric Epidemiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), , University of Gothenburg, ; Gothenburg, Sweden
                Article
                1303
                10.1007/s40520-019-01303-6
                7260266
                31489596
                7ec0745f-43ee-4ff6-88d9-95e97328e507
                © The Author(s) 2019

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 25 April 2019
                : 2 August 2019
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100008448, Rune och Ulla Amlövs Stiftelse för Neurologisk och Reumatologisk Forskning;
                Funded by: FundRef http://dx.doi.org/10.13039/501100009787, Sparbanksstiftelsen Sjuhärad;
                Award ID: 0
                Award Recipient :
                Funded by: ALF-agreement
                Award ID: ALF71668
                Award Recipient :
                Funded by: research and development council södra älvsborg
                Funded by: FundRef http://dx.doi.org/10.13039/501100006636, Forskningsrådet om Hälsa, Arbetsliv och Välfärd;
                Award ID: 2008-1229
                Award ID: 2012-1138
                Award ID: 2006-0596
                Award ID: 2008-1111
                Award ID: 2010-0870
                Award ID: 2013-1202
                Award ID: 2013-2300
                Award ID: 2013-2496
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100007416, Swedish Brain Power;
                Award ID: -
                Award Recipient :
                Funded by: Swedish Alzheimer foundation
                Award ID: -
                Award Recipient :
                Funded by: the Alzheimer association zenith award
                Award ID: ZEN-01-3151
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100003745, Stiftelserna Wilhelm och Martina Lundgrens;
                Award ID: -
                Award Recipient :
                Funded by: stiftelsen demensfonden
                Award ID: -
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100003744, Stiftelsen Handlanden Hjalmar Svenssons;
                Award ID: -
                Award Recipient :
                Funded by: Eivin och Elsa K:s Sylvans stiftelse
                Award ID: -
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100009802, Stiftelsen Söderström Königska Sjukhemmet;
                Award ID: -
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/100010815, Stiftelsen för Gamla Tjänarinnor;
                Award ID: -
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100008586, Stiftelsen Professor Bror Gadelius Minnesfond;
                Award ID: -
                Award Recipient :
                Categories
                Original Article
                Custom metadata
                © Springer Nature Switzerland AG 2020

                dizziness,unsteadiness,fear of falling,falls,walking speed,medication

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