Balance disorders in the elderly: Epidemiology and functional impact

Objectives/Hypothesis: To quantify the prevalence and determine the impact of dizziness and balance disorders in the elderly. Study Design: Cross-sectional analysis of a national database. Methods: The balance problems survey module of the 2008 National Health Interview Survey was examined, and cases of reported dizziness or balance problems in persons =65 years old were identified. The prevalence of balance disorders and associated symptoms and their impacts on self-reported functional limitations were determined. The related impact on daily activities for elderly persons with balance problems was quantified. Sex-based differences in balance problems were determined. Results: Among 37.3 +/- 0.9 million elderly persons (mean age, 74.4 +/- 0.1 years; 56.9% +/- 0.9% female), 7.0 +/- 0.2 million persons (19.6% +/- 0.7%) reported a problem with dizziness or balance in the preceding 12 months. Balance problems included difficulty with unsteadiness (68.0%), walking on uneven surfaces (54.8%), vertigo (30.1%), and faintness (29.6%). Prescription medication triggered the balance problem in 18.7%. Among the 50.0% of elderly persons with balance problems who sought care, 85.6%, 30.3%, 23.9%, and 16.8% saw a general practitioner, internist, neurologist, or otolaryngologist, respectively. Of this group, 27.4% reported that balance problems specifically prevented them from participating in activities including exercise (61.2%), social events (45.8%), and driving (47.1%). Females were more likely to experience balance problems than males (21.0% vs. 17.7%, P = .025). Conclusions: Approximately one in five elderly persons experiences annual problems with dizziness or balance. Given the significant prevalence and negative effect of balance problems on daily activities in the elderly, balance disorders merit special attention, particularly in the face of an aging population.