Kao A C, Nanda A, Williams C S, Tinetti M E
Yale University School of Medicine, Department of Internal Medicine, New Haven, USA.
J Am Geriatr Soc. 2001 Jan;49(1):72-5. doi: 10.1046/j.1532-5415.2001.49012.x.
While dizziness has traditionally been considered solely as a symptom of discrete diseases, recent findings from population-based studies of older persons suggest that it may often be a geriatric syndrome with multiple predisposing risk factors, representing impairments in diverse systems. To validate these findings, we identified predisposing risk factors for dizziness in a clinic-based population.
Cross-sectional study.
Geriatric assessment center.
262 consecutive, eligible patients.
Medical history and physical examination data were ascertained and characteristics of patients with and without a report of dizziness were compared.
Seven factors were independently associated with a report of dizziness, namely depressive symptoms, cataracts, abnormal balance or gait, postural hypotension, diabetes, past myocardial infarction, and the use of three or more medications. Of patients with none of these risk factors, none reported dizziness. This proportion rose from 6% among patients with one factor, to 12%, 26%, and 51% among patients with two, three, and four or more factors, respectively.
The finding of similar factors associated with dizziness in previous community-based cohorts and the present clinic-based cohort supports the possibility of a multifactorial etiology of dizziness in many older persons. A multifactorial intervention targeting the factors identified in these studies may be effective at reducing the frequency or severity of dizziness in older patients.
虽然传统上眩晕仅被视为离散疾病的一种症状,但近期针对老年人的基于人群的研究结果表明,它可能常常是一种具有多种诱发风险因素的老年综合征,代表着多种系统的功能障碍。为验证这些发现,我们在一个基于门诊的人群中确定了眩晕的诱发风险因素。
横断面研究。
老年评估中心。
262名连续的合格患者。
确定病史和体格检查数据,并比较有和没有眩晕报告的患者的特征。
七个因素与眩晕报告独立相关,即抑郁症状、白内障、平衡或步态异常、体位性低血压、糖尿病、既往心肌梗死以及使用三种或更多药物。在没有这些风险因素的患者中,没有人报告有眩晕。这一比例从有一个因素的患者中的6%,分别上升到有两个、三个以及四个或更多因素的患者中的12%、26%和51%。
在先前基于社区的队列和当前基于门诊的队列中发现与眩晕相关的类似因素,支持了许多老年人眩晕存在多因素病因的可能性。针对这些研究中确定的因素进行多因素干预,可能有效降低老年患者眩晕的频率或严重程度。