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Lindell E, Odhagen E, Tuomi L. Living with dizziness impacts health-related quality of life among older adults. Laryngoscope Investig Otolaryngol 2024; 9:e1194. [PMID: 38362202 PMCID: PMC10866590 DOI: 10.1002/lio2.1194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 10/16/2023] [Accepted: 11/26/2023] [Indexed: 02/17/2024] Open
Abstract
Objective This study aimed to compare older adults reporting dizziness to those not reporting dizziness regarding health-related quality of life (HRQL), distress due to dizziness, and balance confidence. A secondary aim was to investigate potential association between HRQL, number of falls, balance confidence, and distress due to dizziness. Methods Patients coming for bone density measurements answered questions regarding occurrence of dizziness. Patients reporting dizziness on a daily or weekly basis were considered eligible and invited for investigation at the Ear, Nose and Throat clinic at Södra Älvsborg Hospital, Sweden. Patients not reporting dizziness were considered eligible as controls. All patients answered the Dizziness Handicap Inventory (DHI), Activity Balance Confidence Scale (ABC-scale), and Euro-QoL-5D-3L questionnaires. Results A total of 55 dizzy patients came for physical investigation and answered the questionnaires and 47 non-dizzy participants only answered the questionnaires. The dizzy participants reported lower levels of balance confidence, lower HRQL, more prior falls, and higher levels of distress due to dizziness than the non-dizzy controls. Lower levels of balance confidence and higher level of distress due to dizziness were each associated with lower HRQL. Conclusion Dizziness, unsteadiness, and low balance confidence are associated with HRQL in a negative way. This is important to consider when measuring HRQL in a senior population, since a sensation of unsteadiness may indirectly contribute to low HRQL together with other symptoms. Level of evidence 2b.
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Affiliation(s)
- Ellen Lindell
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity of Gothenburg, Sahlgrenska Academy, Institute of Clinical SciencesGothenburgSweden
- Department of OtorhinolaryngologyRegion Västra Götaland, Södra Älvsborg HospitalBoråsSweden
- Department of Research, Education and InnovationRegion Västra Götaland, Södra Älvsborg HospitalBoråsSweden
| | - Erik Odhagen
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity of Gothenburg, Sahlgrenska Academy, Institute of Clinical SciencesGothenburgSweden
- Department of OtorhinolaryngologyRegion Västra Götaland, Södra Älvsborg HospitalBoråsSweden
- Department of Research, Education and InnovationRegion Västra Götaland, Södra Älvsborg HospitalBoråsSweden
| | - Lisa Tuomi
- Institute of Neuroscience and Physiology, Speech and Language Pathology UnitUniversity of Gothenburg, Sahlgrenska AcademyGothenburgSweden
- Department of Otorhinolaryngology, Head and Neck SurgeryRegion Västra Götaland, Sahlgrenska University HospitalGothenburgSweden
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2
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Licina S, Kjeken I, Førland O, Langeland E, Tuntland H. Exploring Goals and Functional Changes in Reablement for People with Fractures and People with Dizziness and Balance Problems. J Multidiscip Healthc 2023; 16:2323-2337. [PMID: 37601327 PMCID: PMC10439777 DOI: 10.2147/jmdh.s417883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 06/28/2023] [Indexed: 08/22/2023] Open
Abstract
Background Although older people often have challenges with fractures and dizziness/balance problems, knowledge concerning the impact of reablement of people with these conditions is limited. Aim To explore functional changes in reablement for older home-dwelling people with fractures and dizziness/balance problems regarding 1) occupational performance and satisfaction with performance, 2) physical function and 3) health-related quality of life, and 4) which occupations they prioritize as rehabilitation goals. Material and Methods The sample is derived from a nationwide clinically controlled trial in Norway consisting of 149 participants with fractures and 113 with dizziness/balance problems who participated in a four to 10-week reablement program. Data were collected at baseline and at 10-week, 6-month, and 12-month follow-up and were analyzed with paired t-tests and analysis of covariance. Occupational priorities were categorized into sub-areas of occupation. Results Both groups had significant short-, mid-, and long-term improvements in occupational performance and satisfaction with performance. Except for balance from baseline to 12-month follow-up, the fracture group showed significant improvements in physical function and health-related quality of life at all follow-ups. The results varied more in the group with dizziness/balance problems in physical function and health-related quality of life. Functional mobility was the highest prioritized occupational sub-area in both groups. Conclusion The findings of this study provide extended knowledge about goals and functional changes in people with fractures and dizziness/balance problems following a reablement program. Significance Tailoring and individual adjustments according to diagnosis may be important in person-centered care in reablement.
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Affiliation(s)
- Selma Licina
- Department of Occupational Therapy, Prosthetics and Orthotics, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Ingvild Kjeken
- Department of Occupational Therapy, Prosthetics and Orthotics, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Oddvar Førland
- Centre for Care Research Western Norway, Western Norway University of Applied Sciences, Bergen, Norway
| | - Eva Langeland
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Hanne Tuntland
- Department of Occupational Therapy, Prosthetics and Orthotics, OsloMet - Oslo Metropolitan University, Oslo, Norway
- Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
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3
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Kalu ME, Dal Bello-Haas V, Griffin M, Boamah SA, Harris J, Zaide M, Rayner D, Khattab N, Bhatt V, Goodin C, Song JW(B, Smal J, Budd N. Physical mobility determinants among older adults: a scoping review of self-reported and performance-based measures. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2022. [DOI: 10.1080/21679169.2022.2153303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Michael E. Kalu
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Vanina Dal Bello-Haas
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Meridith Griffin
- Department of Health, Aging & Society, Faculty of Social Science, McMaster University, Hamilton, Canada
| | - Sheila A. Boamah
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Jocelyn Harris
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Mashal Zaide
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Daniel Rayner
- Department of Health Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Nura Khattab
- Department of Kinesiology, Faculty of Sciences, McMaster University, Hamilton, Canada
| | - Vidhi Bhatt
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | | | | | - Justin Smal
- Manitoulin Physio Centre, M'Chigeeng, Canada
| | - Natalie Budd
- The Arthtitis and Sports Medicine Centre, Ancaster, Canada
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Ward K, Citrome L. AXS-05: an investigational treatment for Alzheimer's disease-associated agitation. Expert Opin Investig Drugs 2022; 31:773-780. [PMID: 35763451 DOI: 10.1080/13543784.2022.2096006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Agitation is common in patients with Alzheimer's disease (AD). Although nonpharmacologic de-escalation strategies are recommend as first-line treatment, medication is often needed to treat agitation. Currently, there are no FDA-approved medications for this indication. Psychotropics used to treat agitation include antipsychotics, which are notable for their efficacy but also their potential to cause serious side effects. AXS-05, a combination of dextromethorphan and bupropion, is currently being investigated for this indication. AREAS COVERED This review will discuss the pharmacology of AXS-05 and available clinical trial results from completed Phase I and Phase II/III studies assessing the potential for this compound to treat agitation in patients with AD. Ongoing research investigating AXS-05 for this indication will also be highlighted. Resources used for this review include PubMed, Embase, clinicaltrials.gov, and literature available on the manufacturer's website. EXPERT OPINION Early released clinical trial data indicate that AXS-05 may be a useful option to treat agitation in patients with AD, and that it appears to be generally well tolerated. AXS-05 may be especially helpful for patients with comorbid depression, when considering available data from separate phase III studies assessing the efficacy and safety of this compound in the treatment of depression.
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Affiliation(s)
- Kristen Ward
- Clinical Pharmacy Department, University of Michigan College of Pharmacy, Ann Arbor, MI, USA
| | - Leslie Citrome
- Clinical Professor of Psychiatry & Behavioral Sciences, Department of Psychiatry and Behavioral Science, New York Medical College, Valhalla, NY, USA
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Prell T, Finn S, Axer H. How Healthcare Utilization Due to Dizziness and Vertigo Differs Between Older and Younger Adults. Front Med (Lausanne) 2022; 9:852187. [PMID: 35252281 PMCID: PMC8889010 DOI: 10.3389/fmed.2022.852187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 01/26/2022] [Indexed: 11/21/2022] Open
Abstract
Background Vertigo and dizziness are common in older adults. We describe self-reported healthcare utilization because of dizziness and vertigo in older adults attending a tertiary care specialized vertigo center. Methods Data from 765 patients (45% were ≥60 years old) with chronic dizziness and vertigo who attended a daycare multimodal treatment program were recorded. Data included sociodemographic parameters, dizziness-related characteristics, the Body Sensations Questionnaire (BSQ), the Agoraphobic Cognitions Questionnaire (ACQ), and the Hospital Anxiety and Depression Scale (HADS). Also, healthcare utilization, including (1) physician and clinical services, (2) hospitalizations in the year before consulting the vertigo center, (3) prescription of drugs and other professional services were included. Descriptive statistics, exploratory data analysis, and regression models were used. Results Intensity of dizziness was similar in both age groups, however, distress due to dizziness was more severe in younger persons. Dizziness symptoms lasted longer in older adults than in younger persons. Older adults had a somatic diagnosis (74.6 vs. 35.0%) more frequently and reported more falls (37.2 vs. 28.5%) than younger individuals. Anxiety about bodily sensations was higher in younger patients (mean BSQ1 = 9.33 ± 5.6) than in older patients (mean BSQ1 = 6.72 ± 5.4). Older persons had fewer depressive symptoms (mean HADS depression = 5.8 ± 3.6 vs. 6.5 ± 4.1) and less anxiety (mean HADS anxiety = 5.7 ± 3.7 vs. 7.8 ± 4.1) than younger individuals. Younger people were more frequently hospitalized (24.4%) than older adults (16.3%) in the year before consulting the vertigo center. Also, younger patients and patients with non-somatic etiologies had considerably more consultations with healthcare providers than older patients. Older adults received less medication (50.3%), less physiotherapy (41%), and less psychological therapy (11.6%) for vertigo than younger people (59.7, 52.2, 20.4%, respectively). Conclusion Age-associated differences in healthcare utilization were defined in selected patients attending a specialized vertigo center. Since dizziness is frequently a heterogeneous disorder requiring interdisciplinary care, its diagnostic and therapeutic work-up must be improved for older patients with dizziness.
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Affiliation(s)
- Tino Prell
- Department of Geriatrics, Halle University Hospital, Halle, Germany
| | - Sigrid Finn
- Department of Neurology, Jena University Hospital, Jena, Germany.,Center for Vertigo and Dizziness, Jena University Hospital, Jena, Germany
| | - Hubertus Axer
- Department of Neurology, Jena University Hospital, Jena, Germany.,Center for Vertigo and Dizziness, Jena University Hospital, Jena, Germany
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Dizziness Symptoms, Balance Confidence, and Vestibular Function in Older Women Reporting Dizziness and Unsteadiness. Otol Neurotol 2022; 43:e482-e488. [DOI: 10.1097/mao.0000000000003472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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7
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Lindell E, Kollén L, Johansson M, Karlsson T, Rydén L, Fässberg MM, Erhag HF, Skoog I, Finizia C. Dizziness and health-related quality of life among older adults in an urban population: a cross-sectional study. Health Qual Life Outcomes 2021; 19:231. [PMID: 34600557 PMCID: PMC8487566 DOI: 10.1186/s12955-021-01864-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 09/15/2021] [Indexed: 11/10/2022] Open
Abstract
Background Dizziness is a common complaint among older adults and may affect quality of life in a negative way. The aim of this study was to assess health-related quality of life (HRQL), sense of coherence (SOC), self-rated health (SRH) and comorbidity in relation to dizziness, among older persons from an urban population. Methods The study is part of the Gothenburg H70 Birth Cohort Studies (H70). A cross-sectional population-based sample including 662 79-years-olds (404 women, 258 men, 62% response rate) were surveyed with questions regarding dizziness, imbalance, comorbidities and general health. HRQL was assessed using the 36-item Short Form-36 Health Survey (SF-36) and SOC with the 13-items questionnaire Sense of Coherence (SOC-13). Results Half of the participants reported problems with dizziness (54%). Dizziness was negatively associated with HRQL, including after adjusting for comorbidities, especially in the physical domains of SF-36. Having dizziness was also associated with poorer SRH, tiredness and comorbidity among both men and women. SOC (mean total score), however, did not differ between dizzy and non-dizzy participants. Conclusions Dizziness was negatively associated with HRQL, also after adjusting for comorbidities. Identification and treatment of dizziness, when possible, are important because reduction of dizziness symptoms may potentially help to enhance overall well-being in this age group.
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Affiliation(s)
- Ellen Lindell
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska Universitetssjukhuset, Gothenburg University, Gröna Stråket 5, 413 45, Gothenburg, Sweden. .,Department of Otorhinolaryngology, Region Västra Götaland, Sahlgrenska University Hospital, 413 45, Gothenburg, Sweden.
| | - Lena Kollén
- Department of Otorhinolaryngology, Region Västra Götaland, Sahlgrenska University Hospital, 413 45, Gothenburg, Sweden.,Department of Occupational Therapy and Physiotherapy, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, 413 45, Gothenburg, Sweden
| | - Mia Johansson
- Department of Otorhinolaryngology, Region Västra Götaland, Sahlgrenska University Hospital, 413 45, Gothenburg, Sweden.,Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, 413 45, Gothenburg, Sweden
| | - Therese Karlsson
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska Universitetssjukhuset, Gothenburg University, Gröna Stråket 5, 413 45, Gothenburg, Sweden.,Department of Otorhinolaryngology, Region Västra Götaland, Sahlgrenska University Hospital, 413 45, Gothenburg, Sweden
| | - Lina Rydén
- Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), University of Gothenburg, Gothenburg, Sweden
| | - Madeleine Mellqvist Fässberg
- Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), University of Gothenburg, Gothenburg, Sweden
| | - Hanna Falk Erhag
- Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), University of Gothenburg, Gothenburg, Sweden
| | - Ingmar Skoog
- Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), University of Gothenburg, Gothenburg, Sweden
| | - Caterina Finizia
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska Universitetssjukhuset, Gothenburg University, Gröna Stråket 5, 413 45, Gothenburg, Sweden.,Department of Otorhinolaryngology, Region Västra Götaland, Sahlgrenska University Hospital, 413 45, Gothenburg, Sweden
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8
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Lin Se To P, Ajit Singh DK, Whitney SL. Effects of customized vestibular rehabilitation plus canalith repositioning maneuver on gait and balance in adults with Benign Paroxysmal Positional Vertigo: A Randomized Controlled Trial. J Vestib Res 2021; 32:79-86. [PMID: 34151874 DOI: 10.3233/ves-190731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Adults with unilateral posterior canal benign paroxysmal positional vertigo (BPPV) may continue to present with residual dizziness and balance impairments after the canalith repositioning maneuver (CRM). Customized Vestibular rehabilitation (VR) in addition to the standard CRM may improve postural control in adults with BPPV. However, the effectiveness of this intervention for improving dyanmic gait measures in adults with BPPV is unknown. OBJECTIVE We aimed to determine the effectiveness of customized VR in addition to the standard CRM on dynamic gait measures among adults with unilateral posterior canal BPPV. METHODS In this double blind, randomized controlled trial, 28 adults with BPPV were randomized to either control (n = 14, age: 54.36±8.55) or experimental (n = 14, age: 50.71±9.88) groups. The experimental and control groups received customized VR plus standard CRM for six weeks and standard CRM for two weeks respectively. Dynamic gait measures (duration of a complete gait cycle, stride velocity, turning duration and number of steps while turning) were recorded using a portable mobility sensor (iTUG) at baseline, week 4 and 6. A mixed model ANOVA was used to estimate the main effects of the interventions. RESULTS During walking, a group effect was demonstrated on gait duration, stride velocity, turning duration and number of steps while turning (p < 0.05). CONCLUSIONS Six weeks of customized VR performed in addition to the standard CRM was more effective than the standard CRM alone in improving balance and gait in adults with posterior canal BPPV. (252 words).
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Affiliation(s)
- Phui Lin Se To
- Physiotherapy Program & Centre for Healthy Ageing, Faculty of Health Sciences, Universiti Kebangsaan Malaysia.,Department of Physiotherapy, Serdang Hospital, Jalan Puchong, Kajang, Selangor Malaysia
| | - Devinder Kaur Ajit Singh
- Physiotherapy Program & Centre for Healthy Ageing, Faculty of Health Sciences, Universiti Kebangsaan Malaysia
| | - Susan L Whitney
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh
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9
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Lindell E, Karlsson T, Kollén L, Johansson M, Finizia C. Benign paroxysmal positional vertigo and vestibular impairment among older adults with dizziness. Laryngoscope Investig Otolaryngol 2021; 6:488-495. [PMID: 34195370 PMCID: PMC8223472 DOI: 10.1002/lio2.566] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 03/25/2021] [Accepted: 03/31/2021] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE This article aimed to investigate older adults visiting a geriatric institution for a bone density measurement who reported dizziness on a daily or weekly basis (but who are not seeking care for dizziness), according to BPPV, vestibular function, walking abilities, and frequency of falls. METHODS Patients coming for a bone density measurement answered questions regarding occurrence of dizziness. Patients having dizziness on a daily or weekly basis were considered eligible for the study and invited for investigation at the Ear, Nose, and Throat clinic at Södra Älvsborg Hospital, Sweden. The patients answered questions about history of dizziness, medications, and comorbidities. They were also investigated for BPPV, vestibular deficits using the video head impulse test (vHIT), walking speed, Timed Up and Go test (TUG), and for perception of verticality and horizontality and Romberg test. RESULTS A total of 55 patients with dizziness were included. Fifteen (27%) were diagnosed with BPPV. Forty (73%) patients reported falling during the previous year, including 11 with BPPV. Dizziness when turning in bed was more common among patients with BPPV and increased the risk of BPPV 8-fold. CONCLUSION BPPV is common among older adults with dizziness, including among those not seeking medical care. It is important to identify older adults with BPPV and treat the condition since BPPV may contribute to falls. Asking about dizziness when turning in bed can help to distinguish patients with increased risk for BPPV and older adults with dizziness should be investigated for BPPV even when typical history is lacking. Level of evidence: 4.
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Affiliation(s)
- Ellen Lindell
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Department of Otorhinolaryngology, Region Västra GötalandSödra Älvsborg HospitalSweden
| | - Therese Karlsson
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Department of Otorhinolaryngology, Head and Neck Surgery, Region Västra GötalandSahlgrenska University HospitalGothenburgSweden
| | - Lena Kollén
- Department of Otorhinolaryngology, Head and Neck Surgery, Region Västra GötalandSahlgrenska University HospitalGothenburgSweden
- Department of Occupational Therapy and Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Mia Johansson
- Department of Oncology, Region Västra GötalandSahlgrenska University Hospital/SahlgrenskaGothenburgSweden
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Caterina Finizia
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Department of Otorhinolaryngology, Head and Neck Surgery, Region Västra GötalandSahlgrenska University HospitalGothenburgSweden
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Arvidsson Lindvall M, Forsberg A, Appelros P, Anderzén-Carlsson A. "I can manage the challenge" - a qualitative study describing experiences of living with balance limitations after first-ever stroke. Int J Qual Stud Health Well-being 2020; 16:1857044. [PMID: 33323049 PMCID: PMC7744151 DOI: 10.1080/17482631.2020.1857044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Purpose: To describe experiences of living with balance limitations after first-ever stroke. Materials and methods: This study has a qualitative design, comprising interviews with 19 persons with first-ever stroke, ten women and nine men. Their mean age was 77 years and the mean time since stroke was 15 months. Stroke survivors who were able to walk outdoors with or without a walking aid and who were independent in toileting and dressing were invited to participate. Semi-structured individual interviews were performed. An inductive qualitative content analysis of the manifest and latent content was conducted. Results: The results are presented in two themes illustrating the latent content of the data, “Feeling dizzy and unstable is a continuous challenge” and “Feeling confidence despite dizziness and unsteadiness”, and seven categories illustrating the manifest content: Limitations in daily life; Being emotionally affected; The need for physical support; Everything takes time; I can still manage; Feelings of acceptance; and Finding individual solutions. Conclusions: All participants experienced the balance limitations as a continuous challenge in their everyday life, yet they also felt confidence. They had to some degree adapted their activities and were able to manage their daily life.
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Affiliation(s)
- Mialinn Arvidsson Lindvall
- Department of University Health Care Research Center, Faculty of Medicine and Health, Örebro University , Örebro, Sweden
| | - Anette Forsberg
- Department of Physiotherapy, Faculty of Medicine and Health, Örebro University , Örebro, Sweden
| | - Peter Appelros
- Department of University Health Care Research Center, Faculty of Medicine and Health, Örebro University , Örebro, Sweden
| | - Agneta Anderzén-Carlsson
- Department of University Health Care Research Center, Faculty of Medicine and Health, Örebro University , Örebro, Sweden
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11
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Anton SD, Cruz-Almeida Y, Singh A, Alpert J, Bensadon B, Cabrera M, Clark DJ, Ebner NC, Esser KA, Fillingim RB, Goicolea SM, Han SM, Kallas H, Johnson A, Leeuwenburgh C, Liu AC, Manini TM, Marsiske M, Moore F, Qiu P, Mankowski RT, Mardini M, McLaren C, Ranka S, Rashidi P, Saini S, Sibille KT, Someya S, Wohlgemuth S, Tucker C, Xiao R, Pahor M. Innovations in Geroscience to enhance mobility in older adults. Exp Gerontol 2020; 142:111123. [PMID: 33191210 PMCID: PMC7581361 DOI: 10.1016/j.exger.2020.111123] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 02/07/2023]
Abstract
Aging is the primary risk factor for functional decline; thus, understanding and preventing disability among older adults has emerged as an important public health challenge of the 21st century. The science of gerontology - or geroscience - has the practical purpose of "adding life to the years." The overall goal of geroscience is to increase healthspan, which refers to extending the portion of the lifespan in which the individual experiences enjoyment, satisfaction, and wellness. An important facet of this goal is preserving mobility, defined as the ability to move independently. Despite this clear purpose, this has proven to be a challenging endeavor as mobility and function in later life are influenced by a complex interaction of factors across multiple domains. Moreover, findings over the past decade have highlighted the complexity of walking and how targeting multiple systems, including the brain and sensory organs, as well as the environment in which a person lives, can have a dramatic effect on an older person's mobility and function. For these reasons, behavioral interventions that incorporate complex walking tasks and other activities of daily living appear to be especially helpful for improving mobility function. Other pharmaceutical interventions, such as oxytocin, and complementary and alternative interventions, such as massage therapy, may enhance physical function both through direct effects on biological mechanisms related to mobility, as well as indirectly through modulation of cognitive and socioemotional processes. Thus, the purpose of the present review is to describe evolving interventional approaches to enhance mobility and maintain healthspan in the growing population of older adults in the United States and countries throughout the world. Such interventions are likely to be greatly assisted by technological advances and the widespread adoption of virtual communications during and after the COVID-19 era.
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Affiliation(s)
- Stephen D Anton
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Yenisel Cruz-Almeida
- University of Florida, Department of Community Dentistry and Behavioral Science, 1329 SW Archer Road, Gainesville, FL 32610, United States.
| | - Arashdeep Singh
- University of Florida, Department of Pharmacodynamics, College of Pharmacy, 1345 Center Drive, Gainesville, FL 32610, United States.
| | - Jordan Alpert
- University of Florida, College of Journalism and Communications, Gainesville, FL 32610, United States.
| | - Benjamin Bensadon
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Melanie Cabrera
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - David J Clark
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Natalie C Ebner
- University of Florida, Department of Psychology, 945 Center Drive, Gainesville, FL 32611, United States.
| | - Karyn A Esser
- University of Florida, Department of Physiology and Functional Genomics, 1345 Center Drive, Gainesville, FL, United States.
| | - Roger B Fillingim
- University of Florida, Department of Community Dentistry and Behavioral Science, 1329 SW Archer Road, Gainesville, FL 32610, United States.
| | - Soamy Montesino Goicolea
- University of Florida, Department of Community Dentistry and Behavioral Science, 1329 SW Archer Road, Gainesville, FL 32610, United States.
| | - Sung Min Han
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Henrique Kallas
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Alisa Johnson
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Christiaan Leeuwenburgh
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Andrew C Liu
- University of Florida, Department of Physiology and Functional Genomics, 1345 Center Drive, Gainesville, FL, United States.
| | - Todd M Manini
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Michael Marsiske
- University of Florida, Department of Clinical & Health Psychology, 1225 Center Drive, Gainesville, FL 32610, United States.
| | - Frederick Moore
- University of Florida, Department of Surgery, Gainesville, FL 32610, United States.
| | - Peihua Qiu
- University of Florida, Department of Biostatistics, Gainesville, FL 32611, United States.
| | - Robert T Mankowski
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Mamoun Mardini
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Christian McLaren
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Sanjay Ranka
- University of Florida, Department of Computer & Information Science & Engineering, Gainesville, FL 32611, United States.
| | - Parisa Rashidi
- University of Florida, Department of Biomedical Engineering. P.O. Box 116131. Gainesville, FL 32610, United States.
| | - Sunil Saini
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Kimberly T Sibille
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Shinichi Someya
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Stephanie Wohlgemuth
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Carolyn Tucker
- University of Florida, Department of Psychology, 945 Center Drive, Gainesville, FL 32611, United States.
| | - Rui Xiao
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Marco Pahor
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
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12
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Lindell E, Kollén L, Johansson M, Karlsson T, Rydén L, Falk Erhag H, Wetterberg H, Zettergren A, Skoog I, Finizia C. Benign paroxysmal positional vertigo, dizziness, and health-related quality of life among older adults in a population-based setting. Eur Arch Otorhinolaryngol 2020; 278:1637-1644. [PMID: 32948896 PMCID: PMC8058011 DOI: 10.1007/s00405-020-06357-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 09/05/2020] [Indexed: 01/14/2023]
Abstract
Purpose Dizziness may affect quality of life in a negative way and contribute to falls. The aim of this study was to investigate and compare 75 years old with dizziness caused by benign paroxysmal positional vertigo (BPPV) to those with general dizziness/impaired balance (non-BPPV related) and to those reporting no dizziness, regarding health-related quality of life (HRQL), falls, tiredness, and walking speed in a population-based setting. Method A cross-sectional population-based sample, including 671 75 years old (398 women, 273 men), was investigated for BPPV, dizziness symptoms, falls, and walking speed. HRQL was assessed using the 36-item Short Form-36 Health Survey (SF-36). Result A total of 67 persons (10%) had symptoms of BPPV with 11 (1.6%) having nystagmus when tested for BPPV. Having BPPV as well as general dizziness/impaired balance was associated with reduced HRQL, more tiredness, enhanced number of falls, and lower walking speed. Furthermore, the risk of having BPPV increased fourfold if symptoms of dizziness when turning in bed was reported. Conclusion Having problems with dizziness is common among senior citizens where BPPV can be an unrecognized cause of dizziness that may impact HRQL and overall well-being. As BPPV is common among older adults, and is potentially curable through reposition maneuvers, it is important to liberally test for, and treat the condition. Information about dizziness when turning in bed can help to pinpoint persons with enhanced risk for BPPV also on a population-based level.
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Affiliation(s)
- Ellen Lindell
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital, Gothenburg University, 413 45, Göteborg, Sweden. .,Region Västra Götaland, Department of Otorhinolaryngology, Sahlgrenska University Hospital, 413 45, Göteborg, Sweden.
| | - Lena Kollén
- Region Västra Götaland, Department of Otorhinolaryngology, Sahlgrenska University Hospital, 413 45, Göteborg, Sweden.,Department of Occupational Therapy and PhysiotherapyInstitute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, 413 45, Göteborg, Sweden
| | - Mia Johansson
- Region Västra Götaland, Department of Otorhinolaryngology, Sahlgrenska University Hospital, 413 45, Göteborg, Sweden.,Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, 413 45, Göteborg, Sweden
| | - Therese Karlsson
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital, Gothenburg University, 413 45, Göteborg, Sweden.,Region Västra Götaland, Department of Otorhinolaryngology, Sahlgrenska University Hospital, 413 45, Göteborg, Sweden
| | - Lina Rydén
- Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Göteborg, Sweden
| | - Hanna Falk Erhag
- Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Göteborg, Sweden
| | - Hanna Wetterberg
- Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Göteborg, Sweden
| | - Anna Zettergren
- Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Göteborg, Sweden
| | - Ingmar Skoog
- Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Göteborg, Sweden
| | - Caterina Finizia
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital, Gothenburg University, 413 45, Göteborg, Sweden.,Region Västra Götaland, Department of Otorhinolaryngology, Sahlgrenska University Hospital, 413 45, Göteborg, Sweden
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13
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Yang TH, Xirasagar S, Cheng YF, Wu CS, Kuo NW, Lin HC. Peripheral Vestibular Disorders: Nationwide Evidence From Taiwan. Laryngoscope 2020; 131:639-643. [PMID: 32621538 DOI: 10.1002/lary.28877] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 05/25/2020] [Accepted: 06/01/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVES/HYPOTHESIS This study aimed to evaluate the prevalence of peripheral vestibular disorders in an Asian population of predominantly Han Chinese ethnicity. STUDY DESIGN Cross-sectional study. METHODS Patients with a peripheral vertigo disorder were identified from the Taiwan Health Insurance Research Database, a database of all medical claims of a randomly selected, population-representative sample of 2 million enrollees of Taiwan's National Health Insurance system covering over 99% of Taiwan's citizens. In 2016, 59,986 patients received a diagnosis of peripheral vestibular disorders in Taiwan. We calculated the population-wide prevalence rates of peripheral vestibular disorders in 2016 by sex and age group (20 to 24, 25 to 29, 30 to 34, 35 to 39, 40 to 44, 45 to 49, 50 to 54, 55 to 59, 60 to 64, 65 to 69, and ≥ 70 years) stratified into five urbanization levels. RESULTS The prevalence rate of peripheral vestibular disorders was 2,833.4 per 100,000 population during the year. Prevalence of Meniere's disease was 70.4 per 100,000, benign paroxysmal positional vertigo, 446.4, vestibular neuritis 307.2, and other or unspecified peripheral vestibular dizziness, 2,009.5 per 100,000. Prevalence rates steadily increased with age for every type of peripheral vestibular disorder, and were higher among females compared to males. The female-to-male gender ratios were 1.84, 1.89, and 1.93 for Meniere's disease, vestibular neuritis, and other peripheral vestibular dizziness, respectively. Counties with the lowest urbanization level had the highest prevalence rates of all types of peripheral vestibular disorders except vestibular neuritis. CONCLUSIONS Results showed that peripheral vestibular disorders are common in Taiwan, increase with age, are predominantly female, and show higher prevalence in rural areas. LEVEL OF EVIDENCE 2b Laryngoscope, 131:639-643, 2021.
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Affiliation(s)
- Tzong-Hann Yang
- Department of Otorhinolaryngology, Taipei City Hospital, Taipei, Taiwan.,Department of Speech, Language, and Audiology, National Taipei University of Nursing and Health, Taipei, Taiwan.,Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Sudha Xirasagar
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, U.S.A
| | - Yen-Fu Cheng
- Department of Speech, Language, and Audiology, National Taipei University of Nursing and Health, Taipei, Taiwan.,Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Otolaryngology-Head and Neck Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chuan-Song Wu
- Department of Otorhinolaryngology, Taipei City Hospital, Taipei, Taiwan.,Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,College of Science and Engineering, Fu Jen University, New Taipei City, Taiwan
| | - Nai-Wen Kuo
- School of Health Care Administration, College of Management, Taipei Medical University, Taipei, Taiwan
| | - Herng-Ching Lin
- School of Health Care Administration, College of Management, Taipei Medical University, Taipei, Taiwan.,Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan
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14
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Abstract
The diaphragm muscle is the most important contractile district used for breathing. Like other muscles in the human body, it is subject to ageing and sarcopenia. Sarcopenia can be classified as primary (or age-related) when there are no local or systemic pathologies that cause a functional and morphological detriment of skeletal musculature. Secondary sarcopenia occurs when there is a cause or more pathological causes (illness, malnutrition, immobility) related or unrelated to ageing. In the elderly population, transdiaphragmatic pressure (Pdi) decreases by 20-41%, with a decline in the overall strength of 30% (the strength of the expiratory muscles also decreases). The article discusses the adaptation of the diaphragm muscle to ageing and some other ailments and co-morbidities, such as back pain, emotional alterations, motor incoordination, and cognitive disorders, which are related to breathing.
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Affiliation(s)
- Bruno Bordoni
- Physical Medicine and Rehabilitation, Foundation Don Carlo Gnocchi, Milan, ITA
| | - Bruno Morabito
- Physical Medicine and Rehabilitation, School of Osteopathic Centre for Research and Studies, Milan, ITA
| | - Marta Simonelli
- Integrative/Complimentary Medicine, French-Italian School of Osteopathy, Pisa, ITA
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