Lasisi A O, Gureje O
Department of Otorhinolaryngology, University of Ibadan, Nigeria.
J Laryngol Otol. 2010 Sep;124(9):957-62. doi: 10.1017/S0022215110000538. Epub 2010 Mar 23.
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.
This study aimed to determine the prevalence of disability, and the quality of life, among elderly persons with dizziness living in the community.
Longitudinal cohort study of dizziness among elderly persons (i.e. aged 65 years and over) residing in Yoruba-speaking areas of Nigeria.
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.
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) > or =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.
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.
头晕在老年人中很常见。然而,对于其对生活质量和残疾的影响知之甚少,尤其是在老年人数量不断增加的发展中国家。
本研究旨在确定社区中头晕老年人的残疾患病率和生活质量。
对居住在尼日利亚约鲁巴语地区的老年人(即65岁及以上)进行头晕的纵向队列研究。
通过多阶段分层区域概率抽样对家庭进行选择,与受访者进行面对面访谈。头晕基于自我报告,使用世界卫生组织生活质量评估简版测量与健康相关的生活质量。
在1281名老年受访者中,有318人报告并确诊头晕,患病率为24.8%。受访者包括197名(61.9%)女性和121名(38.1%)男性。39名受访者(12.3%)年龄在65 - 69岁,91名(28.6%)年龄在70 - 74岁,66名(20.8%)年龄在75 - 79岁,122名(38.4%)年龄≥80岁。日常生活活动中的残疾患病率为29.56%,工具性日常生活活动中的残疾患病率为10.1%。性别影响不显著。日常生活活动中的残疾患病率(p = 0.00)和工具性日常生活活动中的残疾患病率(p = 0.00)随年龄显著增加。单因素分析显示,与无头晕的老年受访者相比,有头晕的老年受访者在日常生活活动中的残疾(p = 0.00)、工具性日常生活活动中的残疾(p = 0.01)、家庭互动差(p = 0.00)、社区参与度低(p = 0.00)、整体健康状况差(p = 0.00)、当前抑郁(p = 0.01)以及久坐(p = 0.00)和剧烈活动困难(p = 0.00)方面明显更常见。相比之下,认知障碍(p = 0.05)无显著相关性。与无头晕的老年受访者相比,我们的老年受访者中出现剧烈或久坐活动困难的概率分别为2.6和1.9。同样,日常生活活动中出现残疾、当前抑郁和痴呆的概率均为1.6。对年龄、性别、医疗状况和残疾情况进行的逻辑回归分析证实,头晕与认知功能恶化显著相关。同样,头晕与总生活质量降低显著相关(p = 0.00),也与研究工具的身体(p = 0.00)、心理(p = 0.00)和环境(p = 0.00)领域的降低相关。
在头晕的老年人中,需要帮助的严重残疾患病率很高。此外,仅头晕就显著降低了这些人的整体生活质量,以及他们在身体、心理和环境参数方面的生活质量。这些信息将有助于为老年人制定政策规划。