RESUMO
BACKGROUND: Visual vertigo (VV), triggered by environmental or dynamic visual stimuli and repetitive visual patterns, can affect daily life activities. The Visual Vertigo Analogue Scale (VVAS) is a valid and reliable self-administered questionnaire to assess VV, which has been culturally adapted to the Argentine population but has not been validated. OBJECTIVE: To validate the Argentine version of VVAS (VVAS-A) by confirming its psychometric properties in patients with vestibular disorders. METHODS: Vestibular patients (nâ=â82) completed the VVAS-A and the Dizziness Handicap Inventory Argentine version (DHI-A) during their initial visit and one week later. The VVAS-A's internal consistency, test retest reliability, ceiling and floor effects, and construct validity were determined. Test-retest data (nâ=â71) was used to calculate reliability using the intraclass correlation coefficient (ICC 2.1). RESULTS: A ceiling effect was observed in 12 patients (14.6%). Internal consistency was acceptable (Cronbach's alpha: 0.91). The reliability was râ=â0.764 [CI 95%: 0.7 -0.86]). Correlations were observed between the VVAS-A and the total DHI-A score (rhoâ=â0.571), the DHI-A physical subscale (rho: 0.578), and DHI-A functional and emotional subscales of the DHI-A (rho: 0.537 and 0.387, respectively). CONCLUSION: The VVA-A is a valid, reliable tool to evaluate VV in patients with vestibular disorders.
Assuntos
Vertigem , Doenças Vestibulares , Avaliação da Deficiência , Tontura/psicologia , Humanos , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários , Vertigem/diagnósticoRESUMO
ABSTRACT INTRODUCTION: Dizziness is one of the most prevalent symptoms in the elderly. Anxiety and depression are common in dizzy adult patients, but there is scarce information about comorbidity between vestibular disturbances and psychiatric disorders in the aged. OBJECTIVE: To assess the prevalence of anxiety and depression disorders in elderly with chronic dizziness of vestibular origin. METHODS: Transversal study that used the Brazilian version of the Composite International Diagnostic Interview 2.1 to assess anxiety and depressive disorders in elderly patients (≥60 years old) with chronic dizziness. RESULTS: Most of the 44 patients included in the study were female (88.6%) with a mean age of 71 years (±7.5), 68.1% had experienced dizziness for 1 year or more. The most prevalent diagnosis was benign paroxysmal positional vertigo (52.3%). The prevalence of generalized anxiety disorder and specific phobias during life were 29.5% and 22.7%, respectively, and, in the last 12 months, 18.2% and 15.9%. There was no patient with panic disorder, agoraphobia or social phobia. The prevalence of depressive disorder during life was 45.4%, and, in the last 12 months, were 11.3%. CONCLUSION: Aged patients with chronic dizziness had high prevalence of some mental disorders.
RESUMO INTRODUÇÃO: A tontura é um dos sintomas clínicos mais prevalentes entre idosos. Sintomas ansiosos e depressivos são frequentes em pacientes adultos não idosos com tontura, porém há pouca informação sobre a comorbidade das doenças vestibulares e transtornos mentais em idosos. OBJETIVO: Avaliar a prevalência de transtornos ansiosos e depressivos em idosos com tontura crônica de origem vestibular. MÉTODO: Estudo de corte transversal que utilizou como instrumento a versão brasileira do Composite International Diagnostic Interview 2.1 (CIDI) para avaliar transtornos ansiosos e depressivos em idosos (≥ 60 anos) com tontura crônica. RESULTADOS: Foram incluídos 44 pacientes, a maioria do gênero feminino (88,6%), idade média de 71 anos, 68,1% apresentava tontura há mais de um ano, e 52,3% apresentavam diagnóstico de vertigem posicional paroxística benigna. A prevalência de transtorno de ansiedade generalizada e fobias específicas na vida foi de 29,5% e 22,7%, respectivamente, e, nos últimos 12 meses, de 18,2% e 15,9% respectivamente. Não houve casos de transtorno do pânico, agorafobia e fobia social. A prevalência de transtorno depressivo na vida foi 45,4%, e, nos últimos 12 meses, foi 11,3%. CONCLUSÃO: Encontrou-se elevada prevalência de certos transtornos mentais em idosos com tontura crônica.
Assuntos
Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos de Ansiedade/psicologia , Transtorno Depressivo/psicologia , Tontura/psicologia , Doença Crônica , Estudos Transversais , PrevalênciaRESUMO
INTRODUCTION: Dizziness is one of the most prevalent symptoms in the elderly. Anxiety and depression are common in dizzy adult patients, but there is scarce information about comorbidity between vestibular disturbances and psychiatric disorders in the aged. OBJECTIVE: To assess the prevalence of anxiety and depression disorders in elderly with chronic dizziness of vestibular origin. METHODS: Transversal study that used the Brazilian version of the Composite International Diagnostic Interview 2.1 to assess anxiety and depressive disorders in elderly patients (≥ 60 years old) with chronic dizziness. RESULTS: Most of the 44 patients included in the study were female (88.6%) with a mean age of 71 years (± 7.5), 68.1% had experienced dizziness for 1 year or more. The most prevalent diagnosis was benign paroxysmal positional vertigo (52.3%). The prevalence of generalized anxiety disorder and specific phobias during life were 29.5% and 22.7%, respectively, and, in the last 12 months, 18.2% and 15.9%. There was no patient with panic disorder, agoraphobia or social phobia. The prevalence of depressive disorder during life was 45.4%, and, in the last 12 months, were 11.3%. CONCLUSION: Aged patients with chronic dizziness had high prevalence of some mental disorders.
Assuntos
Transtornos de Ansiedade/psicologia , Transtorno Depressivo/psicologia , Tontura/psicologia , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , PrevalênciaRESUMO
BACKGROUND: Dizziness is a common complaint among older adults and has been linked to a wide range of health conditions, psychological and social characteristics in this population. However a profile of dizziness is still uncertain which hampers clinical decision-making. We therefore sought to explore the relationship between dizziness and a comprehensive range of demographic data, diseases, health and geriatric conditions, and geriatric syndromes in a representative sample of community-dwelling older people. METHODS: This is a cross-sectional, population-based study derived from FIBRA (Network for the Study of Frailty in Brazilian Elderly Adults), with 391 elderly adults, both men and women, aged 65 years and older. Elderly participants living at home in an urban area were enrolled through a process of random cluster sampling of census regions. The outcome variable was the self-report of dizziness in the last year. Several feelings of dizziness were investigated including vertigo, spinning, light or heavy headedness, floating, fuzziness, giddiness and instability. A multivariate logistic regression analysis was conducted to estimate the adjusted odds ratios and build the probability model for dizziness. RESULTS: The complaint of dizziness was reported by 45% of elderly adults, from which 71.6% were women (p=0.004). The multivariate regression analysis revealed that dizziness is associated with depressive symptoms (OR = 2.08; 95% CI 1.29-3.35), perceived fatigue (OR = 1.93; 95% CI 1.21-3.10), recurring falls (OR = 2.01; 95% CI 1.11-3.62) and excessive drowsiness (OR = 1.91; 95% CI 1.11-3.29). The discrimination of the final model was AUC = 0.673 (95% CI 0.619-0.727) (p< 0.001). CONCLUSIONS: The prevalence of dizziness in community-dwelling elderly adults is substantial. It is associated with other common geriatric conditions usually neglected in elderly adults, such as fatigue and drowsiness, supporting its possible multifactorial manifestation. Our findings demonstrate the need to expand the design in future studies, aiming to estimate risk and identify possible causal relations.
Assuntos
Atividades Cotidianas , Tontura/diagnóstico , Tontura/epidemiologia , Vigilância da População/métodos , Características de Residência , Atividades Cotidianas/psicologia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Tontura/psicologia , Feminino , Humanos , Masculino , PrevalênciaRESUMO
UNLABELLED: Cognitive and emotional factors may affect balance; psychiatric conditions are a common component in patient dizziness. The treatment of patients with vertigo may be affected to a greater degree by the suffering due to this disease than by the severity of organic changes. OBJECTIVE: This study aimed to investigate associations between vestibular test results and self-reported psychological complaints in patients evaluated during 2009 in an audiology unit at a hospital in Porto Alegre. METHODS: We conducted a retrospective, descriptive-exploratory study of data taken from a database of the software VecWin® and VecWin® 2, developed by Neurograff®. We investigated vestibular test results, reports of psychological symptoms reported spontaneously, and information such as age, sex and the presence of vertigo and/or dizziness. This study consisted of three steps: clustering, exclusion/inclusion and quantification. CONCLUSION: Age and gender and the presence or absence of vertigo and/or dizziness were not variables that influenced the outcomes of vestibular testing. There was a significant association between the presence of self-reported psychological complaints and normal vestibular test results. Thus, it is crucial that professionals pay attention to psychological issues reported by patients when the vestibular history is taken.
Assuntos
Tontura/psicologia , Transtornos Mentais/psicologia , Autorrelato , Vertigem/psicologia , Doenças Vestibulares/psicologia , Adulto , Tontura/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Índice de Gravidade de Doença , Vertigem/diagnóstico , Doenças Vestibulares/diagnóstico , Testes de Função VestibularRESUMO
Fatores cognitivos e emocionais podem afetar o equilíbrio, portanto, condições psiquiátricas são comuns em pacientes otoneurológicos. O tratamento dado ao sujeito vertiginoso pode ser mais influenciado pelo sofrimento e comportamento da doença do que pela gravidade da patologia orgânica. OBJETIVO: Este estudo teve como objetivo verificar a associação entre os resultados do exame vestibular e queixa psicológica autorrelatada, em indivíduos atendidos no ano de 2009, no serviço de audiologia de um hospital em Porto Alegre. MATERIAL E MÉTODO: Foi realizado um estudo retrospectivo, descritivo-exploratório, consultando-se a base de dados dos softwares VecWin® e VecWin® 2 da marca Neurograff®. Foram investigados os resultados do exame vestibular, as queixas referentes aos sintomas psicológicos relatados espontaneamente e idade, sexo e queixa de vertigem e/ou tontura. O trabalho foi realizado em três etapas: agrupamento, exclusão/inclusão e quantificação. CONCLUSÃO: A faixa etária da amostra, o sexo e a presença ou ausência de vertigem e/ou tontura não foram variáveis de influência sobre o resultado do exame vestibular. Houve associação significativa entre a presença de queixa psicológica autorrelatada e o resultado normal do exame vestibular. Assim, é fundamental que os profissionais deem atenção às questões psicológicas relatadas pelo indivíduo na ocasião da anamnese vestibular.
Cognitive and emotional factors may affect balance; psychiatric conditions are a common component in patient dizziness. The treatment of patients with vertigo may be affected to a greater degree by the suffering due to this disease than by the severity of organic changes. OBJECTIVE: This study aimed to investigate associations between vestibular test results and self-reported psychological complaints in patients evaluated during 2009 in an audiology unit at a hospital in Porto Alegre. METHODS: We conducted a retrospective, descriptive-exploratory study of data taken from a database of the software VecWin® and VecWin® 2, developed by Neurograff®. We investigated vestibular test results, reports of psychological symptoms reported spontaneously, and information such as age, sex and the presence of vertigo and/or dizziness. This study consisted of three steps: clustering, exclusion/inclusion and quantification. CONCLUSION: Age and gender and the presence or absence of vertigo and/or dizziness were not variables that influenced the outcomes of vestibular testing. There was a significant association between the presence of self-reported psychological complaints and normal vestibular test results. Thus, it is crucial that professionals pay attention to psychological issues reported by patients when the vestibular history is taken.
Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tontura/psicologia , Transtornos Mentais/psicologia , Autorrelato , Vertigem/psicologia , Doenças Vestibulares/psicologia , Tontura/diagnóstico , Estudos Retrospectivos , Índice de Gravidade de Doença , Testes de Função Vestibular , Vertigem/diagnóstico , Doenças Vestibulares/diagnósticoRESUMO
INTRODUCTION AND OBJECTIVES: The Dizziness Handicap Inventory is a useful tool for quantifying self-perceived handicap in patients with vertigo, dizziness or unsteadiness and its impact on daily living activities. The Dizziness Handicap Inventory identifies functional, physical and emotional disorders related to balance disturbance. Our objective was to cross-culturally adapt the Peninsular Spanish version of the Dizziness Handicap Inventory for use in Argentina and validate the adapted Argentinian version. METHODS: We included both healthy subjects and patients with vertigo, dizziness or unsteadiness, aged 18 to 85 years, native Spanish-speaking Argentinians. We introduced linguistic and cultural modifications to the Peninsular Spanish version to obtain the Argentinian one. This version was given twice to 108 patients, 24 to 72 h apart. Internal consistency, test-retest reliability and construct validity were assessed using a visual analogue scale, the Romberg test, the tandem Romberg test and the tandem gait test. RESULTS: We found high internal consistency (α=0.87) and very high test-retest reliability for the total Dizziness Handicap Inventory score (intraclass correlation coefficient: 0.98) and its subscales. The total Dizziness Handicap Inventory and the functional subscale were found to correlate significantly with the Romberg and tandem Romberg tests. The emotional subscale showed a significant correlation with the Romberg test and the eyes-open tandem Romberg test (P<.05) CONCLUSIONS: The Argentinian version of the Dizziness Handicap Inventory proved to be a reliable and valid tool to quantify self-perceived handicap resulting from vertigo, dizziness or unsteadiness.
Assuntos
Cultura , Pessoas com Deficiência/psicologia , Tontura/psicologia , Inquéritos e Questionários , Atividades Cotidianas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Argentina , Emoções , Feminino , Humanos , Idioma , Masculino , Pessoa de Meia-Idade , Equilíbrio Postural , Reprodutibilidade dos Testes , Autorrelato , Vertigem/psicologia , Adulto JovemRESUMO
BACKGROUND: There are several protocols designed to treat vestibular disorders that focus on habituation, substitution, adaptation, and compensation exercises. However, protocols that contemplate not only vestibular stimulation but also other components that are essential to the body balance control in older people are rare. This study aims to compare the effectiveness of two vestibular rehabilitation protocols (conventional versus multimodal) on the functional capacity and body balance control of older people with chronic dizziness due to vestibular disorders. METHODS/DESIGN: A randomized, single-blind, controlled clinical trial with a 3 months follow-up period will be performed. The sample will be composed of older individuals with a clinical diagnosis of chronic dizziness resulting from vestibular disorders. The subjects will be evaluated at baseline, post-treatment and follow-up. Primary outcomes will be determined in accordance with the Dizziness Handicap Inventory (functional capacity) and the Dynamic Gait Index (body balance). Secondary outcomes include dizziness features, functional records, body balance control tests, and psychological information. The older individuals (minimum sample n = 68) will be randomized to either the conventional or multimodal Cawthorne&Cooksey protocols. The protocols will be performed during individual 50-minute sessions, twice a week, for 2 months (a total of 16 sessions). The outcomes of both protocols will be compared according to the intention-to-treat analysis. DISCUSSION: Vestibular rehabilitation through the Cawthorne&Cooksey protocol has already proved to be effective. However, the addition of other components related to body balance control has been proposed to improve the rehabilitation of older people with chronic dizziness from vestibular disorders. TRIAL REGISTRATION: ACTRN12610000018011.