The Impact of Dizziness on the Quality of Life of 235 Individuals who Completed Vestibular Testing in Brazil

Abstract

Introduction In Vestibular Testing (VT), caloric tests allow evaluation of unilateral weakness (UW) and directional preponderance (DP), where different criteria of normality are adopted in Brazil and worldwide. The Brazilian version of the Dizziness Handicap Inventory (Brazilian DHI) evaluates the impact of dizziness on the quality of life of an individual. Objectives The objective of this research is to evaluate the impact of dizziness on the quality of life of patients undergoing VT, and to relate these findings to the results obtained according to national and international criteria. Methods Cross-sectional analytic study of 235 patients referred for VT in two hospitals. The authors performed the Brazilian DHI, history, static, and dynamic balance tests, positional nystagmus, and the Dix-Hallpike maneuver, as well as vectoelectronystagmography. Subjects were divided into three groups according to UW and DP values. Descriptive statistics and comparisons between groups were performed, considering a significance level of 5% in all analyses. Results Patients groups had 20.9% men, and 79.1% women. There was no significant difference between groups for the scores obtained in the Brazilian DHI. There was, however, a statistically significant difference in the redistribution of individuals according to the UW and DP values. Conclusion There was no relationship between VT results and the impact of dizziness in the quality of life. A review of normal values for UW and DP adopted in Brazil is suggested, as well as the application of the Brazilian DHI as an additional tool to evaluate the impact of dizziness on quality of life in all patients undergoing VT.

The diagnostic challenge of dizziness: computed tomography and magnetic resonance imaging findings

“…The ability of human beings to remain upright, to accelerate, and to rotate, without wavering or falling, is called equilibrium, or balance. The maintenance of balance requires appropriate interaction among the vestibular, visual, and proprioceptive systems ( 1 ) . Disturbances in the relationship among these systems usually manifest as dizziness.…”

“…Disturbances in the relationship among these systems usually manifest as dizziness. Dizziness occurs in 5–10% of the world population and in 65% of individuals over 65 years of age ( 1 ) . The term is nonspecific and usually covers a range of presentations, the most common being vertigo (a false sensation of bodily movement), disequilibrium, and presyncope ( 2 ) .…”

Avaliação quantitativa e qualitativa do equilíbrio corporal em idosas ativas e sua relação com a saúde no geral

“…The increase in the elderly population is a global phenomenon, the result of political, social achievements and new technologies. There is a preponderance of elderly women, since men have a higher rate of mortality due to greater exposure to risk factors, such as smoking and alcoholism (15) .…”

“…According to the literature, which states that the elderly's imbalance can be considered a geriatric syndrome, secondary to diseases in several systems and/ or organs, characterized by multisensory changes (23,24) . Diseases of the circulatory, cardiovascular, neurological, musculoskeletal systems, neoplasms, respiratory diseases and the use of different medications are the main causes of deaths of elderly women in Brazil (15,25) . Metabolic changes are frequent causes of changes in the vestibular system, and may be present in 40% of the population (25,26) .…”

“…Considering that changes in body balance can compromise the Quality of Life (QoL) of the elderly, investigating this aspect is essential (6,7) . To this end, a subjective instrument was developed that specifically assesses the disabling effects that dizziness can cause on a daily basis, measured using the Dizziness Handicap Inventory (DHI) questionnaire, an instrument that assesses self-perception and the impact on quality of life of the affected subjects (8,10) .…”