Dizzyness is a common complaint in primary care settings that has many possible etiologies. These Dutch and British researchers sought to characterize subtypes of dizziness in geriatric patients in primary care and to assess its causes. They performed a cross-sectional diagnostic study among geriatric patients in the Netherlands seen by their family physicians for persistent dizziness. A panel containing a family physician, a geriatrician, and a nursing home physician, reviewed the comprehensive evaluations each patient underwent to determine major and minor contributory causes of dizziness.
The researchers report: "From June 2006 to January 2008, we included 417 patients aged 65 to 95 years. Presyncope was the most common dizziness subtype (69%). Forty-four percent of the patients were assigned more than 1 dizziness subtype. Cardiovascular disease was considered to be the most common major contributory cause of dizziness (57%), followed by peripheral vestibular disease (14%), and psychiatric illness (10%). An adverse drug effect was considered to be the most common minor contributory cause of dizziness (23%). Sixty-two percent of the patients were assigned more than 1 contributory cause of dizziness."
The researchers concluded: "Contrary to most previous studies, cardiovascular disease was found to be the most common major cause of dizziness in elderly patients in primary care. In one-quarter of all patients an adverse drug effect was considered to be a contributory cause of dizziness, which is much higher than reported in previous studies."
This observational study of dizziness in the elderly found most dizziness was multifactorial, with cardiac causes and medication side effects playing a larger role than previously reported.
For the full abstract, click here.
Annals of Family Medicine 8(3):196-205, May/June 2010 © 2010 Annals of Family Medicine, Inc
Causes of Persistent Dizziness in Elderly Patients in Primary Care. Otto R. Maarsingh, Jacquelien Dros, François G. Schellevis, et al. Correspondence to Otto R. Maarsingh: o.maarsingh@vumc.nl
Category: A.General/Unspecified. Keywords: dizzynes, elderly, presyncope, vertigo, primary care, cross- sectional diagnostic study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 16 July 2010
