Dizziness is a standard grievance related to multiple causes and resultant morbidity; nevertheless, it stays unclear whether symptomatic dizziness is related to all-cause and cause-specific mortality.

A recent JAMA Otolaryngoly-Head Neck Surgery study assesses the associations between symptomatic dizziness, its various manifestations, and all-cause and cause-specific mortality.

Study: Association of Symptomatic Dizziness With All-Cause and Cause-Specific Mortality. Image Credit: Tunatura / Shutterstock.com

Background

Dizziness has a lifetime prevalence of 15-36% and is a widespread grievance in the final population. Consequently, it’s related to more healthcare visits, risk of falls, disability, and hospital admissions. Annually, dizziness accounts for two.8 million visits to the emergency department.

Dizziness will be brought on by benign or severe conditions, the latter of which may include brain tumors and stroke. This wide selection of things contributing to dizziness results in the non-specific property of symptomatic dizziness, which may present in the shape of disequilibrium, imbalance, and lightheadedness. Thus, it’s imperative to elucidate the underlying causes of dizziness and the manifestations of health outcomes.

Concerning the study

The present study used a cohort of middle-aged and older United States adults to evaluate the association between all-cause and cause-specific mortality and dizziness. To this point, this association has not been extensively studied in the prevailing literature.

Data on mortality were obtained from the National Health and Nutrition Examination Survey (NHANES). At a median of 15 years, NHANES is the longest follow-up mortality data that gives insights into the association between all-cause and cause-specific mortality, dizziness, and manifestations.

Individuals 40 years and older who’ve previously answered questions on symptomatic dizziness inside the past 12 months were included within the evaluation. The information were analyzed between February and August 2023, with the exposure variable being self-reported symptomatic dizziness.

The first outcomes included all-cause and cause-specific mortality, the latter of which included mortality because of diabetes, cancer, heart problems, and unintentional injuries. Within the regression evaluation, data were adjusted in accordance with demographics and medical history. 

Key findings

The mortality risk was higher amongst individuals with symptomatic dizziness within the last 12 months, including its manifestations. Nonetheless, cancer-specific mortality couldn’t be definitively assessed because of the imprecision of the estimates.

When considering diabetes-, cancer-, and cardiovascular-specific mortality, mortality rates risks were higher. Comparatively, mortality risks weren’t correlated with unintentional injuries. 

For all-cause or any cause-specific mortality, individuals reporting positional dizziness weren’t related to higher mortality. Symptomatic dizziness, particularly difficulty with balance or falls, was related to an increased risk of all-cause mortality, as shown by multivariable Cox proportional hazard models. Symptomatic dizziness without falls or balance issues was not related to an increased mortality risk.

One novel finding of the present study was the association between diabetes-specific mortality and symptomatic dizziness, which might be because of peripheral neuropathy and microangiopathy-induced ischemic changes in vestibular organs that result in a way of imbalance. Importantly, cardiovascular diseases or diabetes may induce dizziness through other mechanisms that do indirectly contribute to mortality.

Moreover, reports of dizziness without falls or balance issues weren’t related to higher mortality. Physical examination and follow-up questions related to frequency, duration, and characteristics are essential for patients with symptomatic dizziness. 

Conclusions

Symptomatic dizziness was related to the next risk of all-cause mortality and mortality secondary to diabetes and heart problems. In america, reports of symptomatic dizziness are more likely to increase because the population continues to age. Thus, future research is required to discover interventions for the effective management of dizziness and its effect on mortality.

A key limitation of the present study is that the self-reports are depending on individual respondent interpretation and recall bias. Moreover, the reports were obtained on the time of NHANES participation.

Data on exact dates and changes in status were unavailable, which could have biased the outcomes. For cause-specific mortalities, similar to unintentional injury, the underlying causes might be heterogeneous, and a limited variety of events could have led to the dearth of associations. 

One other limitation is the observational nature of the info, which prevented the establishment of any causal relationships. Questions on dizziness, similar to lightheadedness or room-spinning sensation, also lacked clinical meaning.

Despite controlling for major confounding aspects and mediators, residual confounding because of other unmeasured aspects couldn’t be excluded.