Home⇛Philippine Scientific Journal⇛vol. 52 no. 2 (2019)

Clinical Profile of Geriatric Patients with Dizziness in the Department of Otorhinolaryngology – Head and Neck Surgery at Veterans Memorial Medical Center: A Descriptive Study

Sherwin N. Agustin | Celso V. Ureta | Natividad A. Almazan

 

Abstract:

Objective: To determine the demographic profile and clinical – functional characteristics of geriatric patients with dizziness seen at the Otorhinolaryngology – Head and Neck Surgery OPD clinic and ER Complex of a Tertiary Institution, and correlate it with the incapacitating effect of dizziness as to emotional, physical and functional aspects using the Filipino Dizziness Handicap Index (FDHI). Study Design: Descriptive Cross Sectional Study. Setting: Tertiary Government Hospital. Particpants: Forty six (46) geriatric patients with dizziness using convenience sampling. Results: All elderly dizzy patients aged 65 years old and above were included in the study. Socio-demographic profile, clinical – functional profile and clinical characteristics of dizziness were the variables assessed from all the participants including a 25-item questionnaire of Filipino Dizziness Handicap Index (FDHI) to assess the incapacitating effects of dizziness as to emotional, physical and functional domains. For the Socio-demographic profile, majority of the elderly dizzy patients who responded were within the age bracket of 65-75 years old, female, married and were college graduates. For the Clinical – Functional characteristics of dizziness, 90.9% of the elderly dizzy patients were using waking aids and 83.3% experienced incidence of fall. The prevalence of anxiety and depression among elderly patients suffering from dizziness seen at OPD and ER were 88.2% and 83.3% respectively. For the characteristics of dizziness described the by elderly patients, majority responded that the onset started only for a few days, rotatory in character, usually triggered by head turning from side to side and occurring more than once a month. For the correlation of the FDHI scores with the Clinical – Functional characteristics of dizziness, there was a significantly high FDHI – functional and emotional score among elderly dizzy patients who use walking aids and are anxious and depressed. Conclusion: There is still a high prevalence of elderly female patients with dizziness seen at ENT OPD and ER at 86.2%. However there is no significant correlation with the FDHI score that was established. The high FDHI score for the elderly dizzy patients using walking aids is statistically significant in affecting the physical, emotional and functional capabilities of these elderly individuals that poorly affects their quality of life. The high FDHI score of anxiety and depression among elderly dizzy patients is statistically significant, in which it impairs their ability to adapt psychosocially and to function independently.



References:

  1. Bittar RSM, Mezzalira R, Grasel SS, and Oiticica J. Dizziness Profile and Clinical Features: A Population Based Survey in São Paulo City, Brazil. Braz J Otorhinolaryngol [Internet]. 2015 Feb [cited 2020 Aug16]; 2(1):1-5.Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2358-04292015000100006&lng=en.https://doi.org/10.5935/MedicalExpress.2015.01.06.
  2. Galimi R. Vertigo and Dizziness in the Elderly: Evaluation and Assessment. G Gerontol [Internet]. 2011 May [cited 2020 Aug 16];59:244-250. Available from: https://pdfs.semanticscholar.org/53c0/60697eb77d021839ab734b6aab3e2ca57494.pdf
  3. Fernández L, Breinbauer HA and Delano PH Vertigo and dizziness in the elderly. Front. Neurol [Internet]. 2015 Jun [cited 2020 Aug 16];6:1-6.Available from: https://www.frontiersin.org/articles/10.3389/fneur.2015.00144/ full DOI: 10.3389/fneur.2015.00144
  4. Hullar TE, Zee DS, and Minor LB. Evaluation of the Patient with Dizziness. In: Flint PW, Haughey BH, Lund V, Niparko JK, Robbins T, Thomas R, and Lesperance MM, editors. Cummings Otolaryngology Head and Neck Surgery. 6th ed. Philadelphia: Mosby Elsevier; 2015. p. 1133-1150.
  5. Gananca FF, Gazzola JM, Gananca CF, Caovilla HH, Gananca MM and Cruz OLM. Elderly Falls Associated with Benign Paroxysmal Positional Vertigo. Braz J Otorhinolar yngol [Internet]. 2010 Jan [cited 2020 Aug 16];76(1):113-20. Available from: https://pubmed.ncbi.nlm.nih.gov/20339699/
  6. Kurre A, Straumann D, Jaw van Gool C, Gloor-Juzi T and Bastiaenen CHG. Gender Differences in Patients with Dizziness and Unsteadiness regarding Self-perceived Disability, Anxiety, Depression and its Associations. Biomedical Central [Internet]. 2012 Feb [cited 2020 Aug 16]:1472-6815. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3352112/
  7. Tamber AL, Wilhelmsen KT, and Strand LI. Measurement properties of the Dizziness Handicap Inventory by Cross-sectional and Longitudinal designs. Health Qual Life Outcomes [Internet]. 2009 Dec [cited 2020 Aug16];7(101):1-12. Available from: https://pubmed.ncbi.nlm.nih.gov/20025754/ DOI: 10.1186/1477-7525-7-101.
  8. Kim SK, Kim YB, Park IS, Hong SJ, Kim H and Hong SM. Clinical Analysis of Dizzy Patients with High Levels of Depression and Anxiety. J Audiol Otol [Internet]. 2016 Jul [cited 2020 Aug 16];20(3):174-178. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5144818/. DOI:10.7874/jao.2016.20.3.174
  9. Philippine Statistics Authority. Highlights of the 2010 Census–Based Population Projections [Internet]. Philippines 2016 [updated 2016 Aug 9; cited 2020 Aug 16]. Available from: https://psa.gov.ph/content/highlights-2010-census-based-population-projections
  10. Rosa TSM, De Moraes AB and Filha VAVS. The Institutionalized elderly: sociodemographic and clinical-functional profiles related to dizziness. Braz J Otorhi nolaryngol [Internet]. 2016 Dec [cited 2020 Aug 16]; 82(2):159-169. Available from: https://www.scielo.br/scielo.php?pid=S1808-86942016000200159&script=sci_arttext
  11. Maarsingh OR, Stam H and Van der Horst HE. A Different Approach of Dizziness in Older Patients: Away from Diagnostic Dance Between Patient and Physician. Frontiers in Med [Internet]. 2014 Dec [cited 2020 Aug 16];1(50):1-3. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC4291845/.DOI:10.3389/fmed.2014.00050
  12. De Moraes SA, De Souza Soares WJ, Rodrigues RAS, Fett WCR, Ferriolli E and Perracini MR. Dizziness in Community-Dwelling Older Adults: A Population-Based Study. Braz J Otorhinolaryngol [Internet]. 2011 Dec [cited 2020 Aug 16];77(6)691-9. Available from: https://pubmed.ncbi.nlm.nih.gov/22183273/
  13. Colcombe SJ, Erickson KI, Scalf PE, and Kim JS. Aerobic exercise training increases brain volume in aging humans. J Gerontology [Internet]. 2006 Dec [cited 2020 Aug 16];61(11):1166-70. Available form: https://www.researchgate.net/publication/6633161_Aerobic_Exercise_Training_Increases_Brain_Volume_in_Aging_Humans. DOI: 10.1093/gerona/61.11.1166
  14. Meireles AE. Physiological – Neurological Changes with Aging Affect the Balance Maintenance System. J Neurosci [Internet]. 2010 Dec [cited 2020 Aug 16];18:103-8. Available from: https://www.jneurosci.org/
  15. Zee DS. Vestibular adaptation. In: Herdman SJ, editor. Vestibular rehabilitation. 1st ed. Philadelphia: F.A. Davis Company; 2000. p. 77-86.
  16. Garcia FV. Disequilibrium and its Management in Elderly Patients. International Tinnitus Journal [Internet]. 2009 [cited 2020 Au 16];15(1):83-90. Available from: http://www.tinnitusjournal.com/articles/disequilibrium-and-its-management-in-elderly-patients.pdf
  17. Gazzola JM, Gananca FF, Aratani MC, Perracini MR, and Gananca MM. Clinical Evaluation of Elderly People with Chronic Vestibular Disorder. Braz J Otorhinolaryngol [Internet]. 2006 Jul-Aug [cited 2020 Aug 16];72(4):515-522. Available from: https://pubmed.ncbi.nlm.nih.gov/17143431/. DOI: 10.1016/s1808-8694(15)30998-8.
  18.  Neki NS, Singh A, Shergill GS, and Kaur A. Vertigo in Elderly – Common but Complicated. JKIMSU [Internet]. 2017 Jan-Mar [cited 2020 Aug 16];6(1):2231 – 4261. Available from: https://www.researchgate.net/publication/313876944_Vertigo_in_Elderly-_Common_but_Complicated
  19. Gassmann KG and Rupprecht R. Dizziness in an older community dwelling population: a multifactorial syndrome. JNHA [Internet]. 2009 May [cited 2020 Aug 16];13 (3):278-82. Available from: https://link.springer.com/article/10.1007/s12603-009-0073-2
  20. Dros J, Maarsingh OR, Leo B, Van der Horst HE, Riet GT, Schellevis FG and Van Weert HCPM. Impact of Dizziness on everyday life in older Primary Care Patients: A Cross-sectional Study. Health Qual Life Outcomes [Internet]. 2011 Jun [cited 2020 Aug 16];9(1):44-51. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3142198/
  21. Teixeira AR, Wender MH, Goncalves AK, De La Rocha Freitas C, Weira dos Santos AMP and Soldera CLC. Dizziness, Physical Exercise, Falls and Depression in Adults and the Elderly. Int Arch Otorhinolaryngol [Internet]. 2015 Nov [cited 2020 Aug 16];20(2):124-131. Available from: https://www.researchgate.net/publication/283708950_Dizziness_Physical_Exercise_Falls_and_Depression_in_Adults_and_the_Elderly. DOI: 10.1055/s-0035-1566304
  22. Garcia FV, Coelho MH, and Figueira ML. Psychological manifestations of vertigo: a pilot prospective observational study in a Portuguese population. Int Tinnitus J [Internet]. 2003 Feb [cited 2020 Aug 16];9(1):42-7. Available from: https://www.researchgate.net/publication/8886536_Psychological_manifestations_of_vertigo_A_pilot_prospective_observational_study_in_a_Portuguese_population
  23. Ramos LR, Rosa TE, Oliveira ZM, Medina MCG and Santos FRG. Profile of the elderly in a Metropolitan area of Southern Brazil: Results of a Household Survey. Rev. Saude Publica [Internet]. 1993 Apr [cited 2020 Aug 16];27(2):87-94. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89101993000200003&lng=en. DOI: https://doi.org/10.1590/S0034-89101993000200003.

Tools


Copyright © 2024  KITE Digital Educational Solutions |  Exclusively distributed by CE-Logic