Dizziness increased the risk of all-cause mortality

A study by US researchers found that symptomatic dizziness was associated with an increased prevalence of all-cause mortality. In addition, as reported in JAMA Otolaryngology-Head & Neck Surgery, dizziness increased the risk of death from cardiovascular disease, cancer and diabetes.

Dizziness can occur for a wide variety of reasons, which is why it is not considered a specific symptom of a particular disease. That said, it is considered one of the most common health complaints in the population, with a lifetime prevalence of 15 to 36 percent. Dizziness is associated with an increased risk of falls, health care visits, hospitalization and disability. Various estimates put the costs associated with dizziness as high as $49.5 billion annually and represent a significant financial burden to healthcare and patients.

Janet Choi and colleagues at the University of Southern California conducted a cohort study in which they examined the association of symptomatic dizziness with all-cause and cause-specific mortality in middle-aged and elderly US adults. The study cohort consisted of 9,000 adults who completed a health survey with the following questions, "In the past 12 months, have you had dizziness, difficulty keeping your balance, or difficulty falling? (yes / no)" and "Which of these symptoms have you experienced? (Dizziness, difficulty keeping your balance, difficulty falling)". The prevalence of any symptomatic dizziness in the 12 months preceding the evaluation was 23.8 percent. The prevalence of subjective dizziness, balance problems, and falling was 18.3 percent, 14.5 percent, and 5.7 percent, respectively.

All-cause mortality rates were estimated for symptomatic dizziness with a median of 16.2 years of follow-up. The mortality rate among those who reported any symptoms of dizziness was 45.6 percent compared with 27.1 percent among those who had no symptoms of dizziness. Mortality rates among those who reported problems with dizziness, maintaining balance and falls were 41.3 percent, 51 percent and 61.7 percent, respectively. Those who experienced dizziness when turning in bed (positional vertigo) had a mortality rate of 38.5 percent.

Additional analysis showed that participants with symptomatic dizziness had an increased risk of mortality from specific causes - cardiovascular disease, diabetes and malignant neoplasms. There was no difference between groups in the risk of mortality from unintentional injuries. In adjusted multivariate proportional hazards models, any symptomatic dizziness was associated with all-cause mortality (hazard ratio 1.29), cardiovascular disease mortality (hazard ratio 1.32), and diabetes-related mortality (hazard ratio 1.66). Symptomatic vertigo was also associated with mortality from neoplasms, but no definitive conclusion can be drawn about the strength of the association.

As the global population continues to age, the prevalence of patients with symptomatic vertigo will continue to increase. Therefore, these data are helpful in assessing the extent of the public health burden of this symptom, including increased mortality.

Sometimes dizziness occurs even when simply getting up from a chair. This is due to a sudden drop in blood pressure. But as Canadian scientists have shown, raising the knee before assuming an upright position helped mitigate this drop and the symptoms of dizziness.