Tinetti M E, Williams C S, Gill T M
Yale University School of Medicine, New Haven, Connecticut, USA.
Ann Intern Med. 2000 Mar 7;132(5):337-44. doi: 10.7326/0003-4819-132-5-200003070-00002.
In previous studies of dizziness, the prevalence of specific causes has varied widely and either no or multiple causes have been identified. Dizziness might be better considered a geriatric syndrome that results from impairment or disease in multiple systems.
To determine the predisposing characteristics and situational factors associated with dizziness.
Population-based, cross-sectional study.
Community.
Probability sample of 1087 community-living persons in New Haven, Connecticut, who were at least 72 years of age.
Episodes of dizziness that occurred for at least 1 month; manifestations of dizziness; and predisposing demographic, medical, neurologic, sensory, and psychological characteristics.
261 participants (24%) reported dizziness; 56% of dizzy persons described several sensations and 74% reported several triggering activities. The adjusted relative risks for characteristics associated with dizziness were 1.69 (95% CI, 1.24 to 2.30) for anxiety, 1.36 (CI, 1.02 to 1.80) for depressive symptoms, 1.27 (CI, 0.99 to 1.63) for impaired hearing, 1.30 (CI, 1.01 to 1.68) for five or more medications, 1.31 (CI, 0.92 to 1.87) for postural hypotension, 1.34 (CI, 0.95 to 1.90) for impaired balance, and 1.31 (CI, 1.00 to 1.71) for past myocardial infarction. The adjusted relative risk for dizziness was 1.38 (CI, 1.27 to 1.49) for each additional characteristic.
The association among characteristics in multiple domains (cardiovascular, neurologic, sensory, psychological, and medication-related) and dizziness, coupled with the multiplicity of sensations and triggering activities, suggests that dizziness may be a geriatric syndrome, similar to delirium and falling. If so, an impairment reduction strategy, proven effective for other geriatric syndromes, may be effective in reducing the symptoms and disabilities associated with dizziness.
在以往关于头晕的研究中，特定病因的患病率差异很大，要么未发现病因，要么发现多种病因。头晕或许更宜被视为一种由多个系统功能受损或疾病导致的老年综合征。
确定与头晕相关的易感特征和情境因素。
基于人群的横断面研究。
社区。
康涅狄格州纽黑文市1087名年龄至少72岁的社区居住者的概率样本。
持续至少1个月的头晕发作；头晕表现；以及易感的人口统计学、医学、神经学、感官和心理特征。
261名参与者（24%）报告有头晕；56%的头晕者描述了几种感觉，74%报告了几种触发活动。与头晕相关特征的调整后相对风险分别为：焦虑为1.69（95%可信区间，1.24至2.30），抑郁症状为1.36（可信区间，1.02至1.80），听力受损为1.27（可信区间，0.99至1.63），服用五种或更多药物为1.30（可信区间，1.01至1.68），体位性低血压为1.31（可信区间，0.92至1.87），平衡受损为1.34（可信区间，0.95至1.90），既往心肌梗死为1.31（可信区间，1.00至1.71）。每增加一个特征，头晕的调整后相对风险为1.38（可信区间，1.27至1.49）。
多个领域（心血管、神经学、感官、心理和药物相关）的特征与头晕之间的关联，再加上感觉和触发活动的多样性，表明头晕可能是一种老年综合征，类似于谵妄和跌倒。如果是这样，一种已被证明对其他老年综合征有效的减少损伤策略，可能对减轻与头晕相关的症状和残疾有效。
