Fall Injury Prevention By Appropriate Screening

Dizziness and vertigo are with the top 3 reasons why patients visit a doctor. Back pain and headaches are the other 2 reasons. Symptoms such as dizziness, vertigo and imbalance actually are estimated to affect 40% of patients 40 years of age and older. Of those age 65 years or older, twentyfive% are estimated to incur a fall and thus a fall related injury. Falling is typically a direct result of dizziness, primarily in this group of the elderly and risk of falling can increase considerably when those individuals have other problems such as hypertension or diabetes, or any of the gamut of neurologic defects such as Parkinsons. A sample report of US emergency room visits, from 1995-2004, showed that vertigo and dizziness were indeed high on the list of reported presenting complaints as cause for reporting to the emergency room. Information from the National Health and Nutrition Examination Survey demonstrated that patients with symptomatic vestibular dysfunction have a 12-fold rise in the likelyhood of suffering a fall.

It has also been shown that more repeated medical consultation, sick leave, and interruption of daily activities in general, have been associated with dizziness symptoms, particularly vestibular vertigo.

Medical research on disorders is commonly disease focused as compared to symptoms related. This generalized approach may actually underestimate the reality of such common symptoms as vertigo and dizziness, which as discussed, rank high as patient complaints in primary care, yet escape accurate diagnosis and remain unexplained in eighty% of cases. Making matters worse, even though symptoms of vertigo and dizziness can be related to a large variety of other conditions, all of which necessitate a multidisciplinary approach to management, said dizziness symptoms infrequently trigger appropriate referral to a qualified specialist for appropriate examination. The most common conditions which cause such symptoms as vertigo and dizziness for the most part remain largely undiagnosed outside of specialty clinics such as my own.

Because of the substantial risk of injury and the resultant decline in independence and/or quality of life following a fall, predicting who is at risk is most helpful, and for individuals who reduce that risk through a fall prevention program such as ours, falls and otherwise looming fall related injuries may be diverted. Our clinic does just that using computerized technology, which ironically, only takes seconds to perform. Balance is not a solo physiologic function. The sensory inputs for balance are vision, vestibular, and proprioceptive feedback. While a person is walking, the brain must instantaneously assimilate this data and execute proper motor planning.

This function must be supported by an adequate neuromusculoskeletal system. All of these factors change with age. Further, any disorder related decline in any of these systems further impairs balance. Bilateral vestibular loss is a significant contributor in 25% of elderly patients with imbalance. Untreated vertigo is an elevated risk factor for falling as well.

Our office, as a community service, does not charge for balance/risk-of-fall analysis. Call my office (below) to be screened.