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Disability and quality of life among community elderly with dizziness: report from the Ibadan Study of Ageing

Published online by Cambridge University Press:  23 March 2010

A O Lasisi*
Affiliation:
Department of Otorhinolaryngology, University of Ibadan, Nigeria
O Gureje
Affiliation:
Department of Psychiatry, University of Ibadan, Nigeria
*
Address for correspondence: Dr A O Lasisi, Senior Lecturer, Department of Otorhinolaryngology, College of Medicine, PO Box 22040, University of Ibadan, Ibadan, Nigeria. E-mail: [email protected]

Abstract

Background:

Dizziness is prevalent among the elderly. However, little is known about its impact on quality of life and disability, especially in developing countries, where the number of elderly people is increasing.

Aim:

This study aimed to determine the prevalence of disability, and the quality of life, among elderly persons with dizziness living in the community.

Setting and design:

Longitudinal cohort study of dizziness among elderly persons (i.e. aged 65 years and over) residing in Yoruba-speaking areas of Nigeria.

Method:

Face-to-face interviews with respondents selected using a multi-stage, stratified area probability sampling of households. Dizziness was based on self-reporting and health-related quality of life was measured using the brief version of the World Health Organization quality of life assessment.

Result:

Dizziness was reported and confirmed in 318/1281 elderly respondents, a prevalence of 24.8 per cent. Respondents comprised 197 (61.9 per cent) women and 121 (38.1 per cent) men. Thirty-nine respondents (12.3 per cent) were aged 65–69 years, 91 (28.6 per cent) 70–74 years, 66 (20.8 per cent) 75–79 years and 122 (38.4 per cent) ≥80 years. The prevalence of disability in activities of daily living was 29.56 per cent, and that of disability in instrumental activities of daily living 10.1 per cent. The influence of gender was not significant. The prevalence of disability in activities of daily living (p = 0.00) and in instrumental activities of daily living (p = 0.00) increased significantly with age. Univariate analysis revealed that disability in activities of daily living (p = 0.00), disability in instrumental activities of daily living (p = 0.01), poor family interaction (p = 0.00), poor community involvement (p = 0.00), overall poor health (p = 0.00), current depression (p = 0.01), and difficulty with sedentary (p = 0.00) and vigorous (p = 0.00) activities were significantly more common among elderly respondents with dizziness, compared with non-dizzy elderly respondents. In contrast, cognitive impairment (p = 0.05) was not significantly correlated. The probabilities of the occurrence of difficulty with vigorous or sedentary mobility in our elderly respondents were 2.6 and 1.9, respectively, compared with non-dizzy elderly respondents. Similarly, the probabilities of the occurrence of disability in activities of daily living, current depression and dementia were 1.6 each. Logistic regression analyses for age, sex, medical conditions and presence of disability confirmed that dizziness was significantly associated with worsened cognition. Similarly, dizziness was significantly associated with reduced total quality of life (p = 0.00), and also with reductions in the physical (p = 0.00), psychological (p = 0.00) and environmental (p = 0.00) domains of the research instrument.

Conclusion:

Among elderly people with dizziness, there was a high prevalence of significant disability requiring assistance. In addition, dizziness alone significantly reduced these individual's overall total quality of life, and their quality of life as regards physical, psychological and environmental parameters. This information will assist policy planning for the elderly.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2010

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References

1Agrawal, Y, Carey, JP, Della Santina, CC, Schubert, MC, Minor, LB. Disorders of balance and vestibular function in US adults. Arch Intern Med 2009;169:938–44CrossRefGoogle ScholarPubMed
2Colledge, N, Lewis, S, Mead, G, Sellar, R, Wardlaw, J, Wilson, J. Magnetic resonance brain imaging in people with dizziness: a comparison with non-dizzy people. J Neurol Neurosurg Psych 2002;72:587–9CrossRefGoogle ScholarPubMed
3Hall, SA, Araujo, AB, Esche, GR, Williams, RE, Clark, RV, Travison, TG et al. Treatment of symptomatic androgen deficiency: results from the Boston Area Community Health Survey. Arch Intern Med 2008;168:1070–6CrossRefGoogle ScholarPubMed
4Bhasin, S, Cunningham, GR, Hayes, FJ, Matsumoto, AM, Snyder, PJ, Swerdloff, RS et al. Testosterone therapy in adult men with androgen deficiency syndromes: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2006;91:19952010CrossRefGoogle ScholarPubMed
5Neuhauser, HK, Radtke, A, von Brevern, M, Lezius, F, Feldmann, M, Lempert, T. Burden of dizziness and vertigo in the community. Arch Intern Med 2008;168:2118–24Google Scholar
6Hannaford, PC, Simpson, JA, Bisset, AF, Davis, A, McKerrow, W, Mills, R. The prevalence of ear, nose and throat problems in the community: results from a national cross-sectional postal survey in Scotland. Fam Pract 2005;22:227–33CrossRefGoogle ScholarPubMed
7Bittar, RS, Pedalini, MEB, Lorenzi, MC, Formigoni, LG. Treating vertigo with vestibular rehabilitation: results in 155 patients. Rev Laryngol Oto Rhinol 2002;123:61–5Google ScholarPubMed
8Hsu, LC, Hu, HH, Wong, WJ, Wang, SJ, Luk, YO, Chern, CM. Quality of life in elderly patients with dizziness: analysis of the Short-Form Health Survey in 197 patients. Acta Otolaryngol 2005;125:55–9Google Scholar
9Lasisi, AO, Santos, MF, Knobel, KA. Vestibular rehabilitation in a university hospital. Braz J Otorhinolaryngol 2008;74:241–7Google Scholar
10Tinetti, ME, Williams, CS, Gill, TM. Health, functional, and psychological outcomes among older persons with chronic dizziness. J Am Geriatr Soc 2000;48:417–21CrossRefGoogle ScholarPubMed
11Gureje, O, Ogunniyi, A, Kola, L, Afolabi, E. Functional disability among elderly Nigerians: results from the Ibadan Study of Ageing. J Am Geriatr Soc 2006;54:1784–9CrossRefGoogle Scholar
12Bekibele, CO, Gureje, O. Self-reported visual impairment and impact on vision-related activities in an elderly Nigerian population: report from the Ibadan Study of Ageing. Ophthalmic Epidemiol 2008;92:612–15Google Scholar
13Kish, L. Survey Sampling. New York: John Wiley, 1965Google Scholar
14National Center for Health Statistics. Evaluation of National Health Interview Survey diagnostic reporting. Vital and Health Statistics 2 1994;120:1116Google Scholar
15Katz, S, Ford, AB, Moskowitz, RW, Jackson, BA, Jaffe, MW. Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. JAMA 1963;185:914–19CrossRefGoogle Scholar
16Nagi, SZ. An epidemiology of disability among adults in the United States. Milbank Memorial Fund Quarterly. Health Soc 1976;54:439–67Google Scholar
17World Health Organization. WHO-Disability Assessment Schedule II. Geneva, Switzerland: World Health Organization, 1999Google Scholar
18Sheehan, DV, Harnett-Sheehan, K, Raj, BA. The measurement of disability. Int Clin Psychopharmacol 1996:11(Suppl):8995CrossRefGoogle ScholarPubMed
19The WHOQoL Group. Development of the World Health Organization Quality of life assessment WHOQoL-BREF. Psychol Med 1998;28:551–8CrossRefGoogle Scholar
20Naumann, VJ, Byrne, GJA. WHOQoL-BREF as a measure of quality of life in older patients with depression. Int Psychogeriatr 2004;16:159–73Google Scholar
21Kessler, RC, Ustun, TB. The World Mental Health (WMH) Survey Initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). Int J Methods Psychiatr Res 2004;13:93121CrossRefGoogle ScholarPubMed
22American Psychiatric Association. DSM-IV: Diagnostic and Statistical Manual of Mental Disorders, 4th edn. Washington DC: American Psychiatric Association, 1994Google Scholar
23Hosmer, DW, Lemeshow, S. Applied Logistic Regression. New York: John Wiley, 2000CrossRefGoogle Scholar
24StataCorp. Stata Statistical Software, version 7.0 for Windows. College Station, Texas: Stata, 2001Google Scholar
25Kroenke, K, Lucas, CA, Rosenberg, ML, Scherokman, BJ. Psychiatric disorders and functional impairment in patients with persistent dizziness. J Gen Intern Med 1993;8:530–5CrossRefGoogle ScholarPubMed
26Moreira, DA, Bohlsen, YA, Momensohn-Santos, TM, Cherubini, AA. Study of the handicap caused by dizziness in patients associated or not with tinnitus complaint [in Spanish]. Arquivos Internacionais de Otorrinolaringologia 2006;10:270–7Google Scholar
27Pedalini, MEB, Alvez, NB, Bittar, RSM, Lorenzi, MC, Colello, L, Izzo, H et al. Balance disturbances in the elderly: group class elucidations approach [in Spanish]. Arq Otorrinolaringol 2002;6:211–16Google Scholar
28Mantello, EB, Moriguti, JC, Rodrigues-Júnior, AL, Ferrioli, E. Vestibular rehabilitation's effect over the quality of life of geriatric patients with labyrinth disease [in Portuguese]. Rev Bras Otorrinolaringol 2008;74:172–80Google Scholar
29Ganança, FF, Castro, AS, Branco, FC, Natour, J. Impact of dizziness on quality of life in patients with peripheral vestibular dysfunction [in Portuguese]. Rev Bras Otorrinolaringol 2004;70:94101CrossRefGoogle Scholar
30Söderman, AH, Bagger-Sjöbäck, D, Bergenius, J, Langius, A. Factors influencing quality of life in patients with Ménière's disease, identified by a multidimensional approach. Otol Neurotol 2002;23:941–8CrossRefGoogle ScholarPubMed
31Yanika, B, Külcüb, DG, Kurtaisc, Y, Boynukalind, S, Kurtarahd, H, Gökmene, D. The reliability and validity of the Vertigo Symptom Scale and the Vertigo Dizziness Imbalance Questionnaires in a Turkish patient population with benign paroxysmal positional vertigo. J Vestib Res 2008;18:159–70CrossRefGoogle Scholar
32Newman-Toker, DE, Hsieh, Y-H, Camargo, CA Jr, Pelletier, AJ, Butchy, GT, Edlow, JA. Spectrum of dizziness visits to US emergency departments: cross-sectional analysis from a nationally representative sample. Mayo Clin Proc 2008;83:765–75Google Scholar
33Mattos, LC, Veras, RP. The prevalence of hearing loss in an elderly population in Rio de Janeiro: a cross-sectional study [in Portuguese]. Rev Bras Otorrinolaringol 2007;73:654–9Google Scholar
34Steven, KN, Lang, IA, Guralnik, JM, Melzer, D. Epidemiology of balance and dizziness in a national population: findings from the English Longitudinal Study of Ageing. Age Ageing 2008;37:300–5CrossRefGoogle Scholar