Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-20T00:20:38.820Z Has data issue: false hasContentIssue false

Investigation of self-reported dizziness in the elderly when lying down or turning over in bed, and possible benign paroxysmal positional vertigo

Published online by Cambridge University Press:  01 April 2019

E Lindell*
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, , Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
T Karlsson
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, , Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
M Johansson
Affiliation:
Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
M Magnusson
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Clinical Sciences, University Hospital of Lund, Sweden
C Finizia
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, , Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
*
Author for correspondence: Dr Ellen Lindell, Department of Otolaryngology, Head and Neck Surgery, Sahlgrenska Universitetssjukhuset, Gröna Stråket 5, 41345 Göteborg, Sweden E-mail: [email protected]

Abstract

Objectives

This study aimed to investigate the rate of dizziness and occurrence of benign paroxysmal positional vertigo in the elderly by physical examination in those reporting dizziness symptoms when lying down or turning over in bed.

Methods

A total of 498 people, aged 70–85 years, were asked to complete a questionnaire regarding dizziness symptoms. Subjects answering that they became dizzy in bed were asked to participate in a physical examination and diagnostic manoeuvres investigating benign paroxysmal positional vertigo.

Results

A total of 324 participants (65 per cent) completed the questionnaire. More than one-quarter (29 per cent) reported dizziness and 32 (10 per cent) reported dizziness when turning in bed. Of these 32 persons, 22 (69 per cent) underwent a physical examination. Six participants tested positive for benign paroxysmal positional vertigo.

Conclusion

Ten per cent of the elderly participants reported positional symptoms, and 6 out of 22 fulfilled diagnostic criteria for benign paroxysmal positional vertigo. Furthermore, benign paroxysmal positional vertigo was established despite a delay between questionnaire completion and investigation, emphasising that this type of dizziness may not be a self-limiting disorder.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited, 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr E Lindell takes responsibility for the integrity of the content of the paper

References

1Ekvall Hansson, E, Mansson, NO, Hakansson, A. Benign paroxysmal positional vertigo among elderly patients in primary health care. Gerontology 2005;51:386–9Google Scholar
2Hanley, K, O'Dowd, T, Considine, N. A systematic review of vertigo in primary care. Br J Gen Pract 2001;51:666–71Google Scholar
3Kollén, L, Horder, H, Moller, C, Frandin, K. Physical functioning in older persons with dizziness: a population-based study. Aging Clin Exp Res 2017;29:197205Google Scholar
4Jonsson, R, Sixt, E, Landahl, S, Rosenhall, U. Prevalence of dizziness and vertigo in an urban elderly population. J Vestib Res 2004;14:4752Google Scholar
5Fernandez, L, Breinbauer, HA, Delano, PH. Vertigo and dizziness in the elderly. Front Neurol 2015;6:144Google Scholar
6Kao, AC, Nanda, A, Williams, CS, Tinetti, ME. Validation of dizziness as a possible geriatric syndrome. J Am Geriatr Soc 2001;49:72–5Google Scholar
7Maarsingh, OR, Dros, J, Schellevis, FG, van Weert, HC, Bindels, PJ, Horst, HE. Dizziness reported by elderly patients in family practice: prevalence, incidence, and clinical characteristics. BMC Fam Pract 2010;11:1910.1186/1471-2296-11-2Google Scholar
8Kollén, L, Frandin, K, Moller, M, Fagevik Olsen, M, Moller, C. Benign paroxysmal positional vertigo is a common cause of dizziness and unsteadiness in a large population of 75-year-olds. Aging Clin Exp Res 2012;24:317–2310.1007/BF03325263Google Scholar
9Grimby, A, Rosenhall, U. Health-related quality of life and dizziness in old age. Gerontology 1995;41:286–98Google Scholar
10Rosso, AL, Eaton, CB, Wallace, R, Gold, R, Stefanick, ML, Ockene, JK et al. Geriatric syndromes and incident disability in older women: results from the Women's Health Initiative Observational Study. J Am Geriatr Soc 2013;61:371–9Google Scholar
11Furman, JM, Cass, SP. Benign paroxysmal positional vertigo. N Engl J Med 1999;341:1590–6Google Scholar
12von Brevern, M, Radtke, A, Lezius, F, Feldmann, M, Ziese, T, Lempert, T et al. Epidemiology of benign paroxysmal positional vertigo: a population based study. J Neurol Neurosurg Psychiatry 2007;78:710–1510.1136/jnnp.2006.100420Google Scholar
13Noda, K, Ikusaka, M, Ohira, Y, Takada, T, Tsukamoto, T. Predictors for benign paroxysmal positional vertigo with positive Dix-Hallpike test. Int J Gen Med 2011;4:809–14Google Scholar
14Mizukoshi, K, Watanabe, Y, Shojaku, H, Okubo, J, Watanabe, I. Epidemiological studies on benign paroxysmal positional vertigo in Japan. Acta Otolaryngol Suppl 1988;447:677210.3109/00016488809102859Google Scholar
15van der Zaag-Loonen, HJ, van Leeuwen, RB, Bruintjes, TD, van Munster, BC. Prevalence of unrecognized benign paroxysmal positional vertigo in older patients. Eur Arch Otorhinolaryngol 2015;272:1521–4Google Scholar
16Oghalai, JS, Manolidis, S, Barth, JL, Stewart, MG, Jenkins, HA. Unrecognized benign paroxysmal positional vertigo in elderly patients. Otolaryngol Head Neck Surg 2000;122:630–410.1016/S0194-5998(00)70187-2Google Scholar
17Craftman, AG, Johnell, K, Fastbom, J, Westerbotn, M, von Strauss, E. Time trends in 20 years of medication use in older adults: findings from three elderly cohorts in Stockholm, Sweden. Arch Gerontol Geriatr 2016;63:2835Google Scholar
18Morin, L, Fastbom, J, Laroche, ML, Johnell, K. Potentially inappropriate drug use in older people: a nationwide comparison of different explicit criteria for population-based estimates. Br J Clin Pharmacol 2015;80:315–2410.1111/bcp.12615Google Scholar
19Haider, SI, Johnell, K, Weitoft, GR, Thorslund, M, Fastbom, J. The influence of educational level on polypharmacy and inappropriate drug use: a register-based study of more than 600,000 older people. J Am Geriatr Soc 2009;57:62–9Google Scholar
20Swedish National Board of Health and Welfare (Socialstyrelsen). Elderly with Regular Medications – Number of Medications as a Risk Marker [in Swedish]. Stockholm: Swedish National Board of Health and Welfare, 2012Google Scholar
21Ziere, G, Dieleman, JP, Hofman, A, Pols, HA, van der Cammen, TJ, Stricker, BH. Polypharmacy and falls in the middle age and elderly population. Br J Clin Pharmacol 2006;61:218–23Google Scholar
22Weidt, S, Bruehl, AB, Straumann, D, Hegemann, SC, Krautstrunk, G, Rufer, M. Health-related quality of life and emotional distress in patients with dizziness: a cross-sectional approach to disentangle their relationship. BMC Health Serv Res 2014;14:317Google Scholar
23Ekwall, A, Lindberg, A, Magnusson, M. Dizzy - why not take a walk? Low level physical activity improves quality of life among elderly with dizziness. Gerontology 2009;55:652–910.1159/000235812Google Scholar
24von Brevern, M, Bertholon, P, Brandt, T, Fife, T, Imai, T, Nuti, D et al. Benign paroxysmal positional vertigo: diagnostic criteria. J Vestib Res 2015;25:105–17Google Scholar
25Dros, J, Maarsingh, OR, van der Horst, HE, Bindels, PJ, Ter Riet, G, van Weert, HC. Tests used to evaluate dizziness in primary care. CMAJ 2010;182:E62131Google Scholar
26Evren, C, Demirbilek, N, Elbistanli, MS, Kokturk, F, Celik, M. Diagnostic value of repeated Dix-Hallpike and roll maneuvers in benign paroxysmal positional vertigo. Braz J Otorhinolaryngol 2017;83:243–8Google Scholar
27Imai, T, Ito, M, Takeda, N, Uno, A, Matsunaga, T, Sekine, K et al. Natural course of the remission of vertigo in patients with benign paroxysmal positional vertigo. Neurology 2005;64:920–1Google Scholar
28Swedish National Board of Health and Welfare (Socialstyrelsen). Indicators of Good Drug Therapy in the Elderly [in Swedish]. Stockholm: Swedish National Board of Health and Welfare, 2017;1106Google Scholar