Neurology
Epidemiology of Balance and Dizziness Problems and Falls in Young Adults: National Longitudinal Study of Adolescent Health (Add Health) Chuan-Ming Li* Chuan-Ming Li Howard J. Hoffman Anne E. Hogan Gregory A. Flamme Jamie M. Bogle Helen S. Cohen
Background: Balance and dizziness problems (BDP) and falls are consequential across all ages.
Methods: Add Health is a longitudinal study of a nationally-representative, school-based cohort of more than 20,000 adolescents recruited from Grades 7–12 in 1994–1995. Waves I (n=20,745) and II (n=14,738) asked: “In the past 12 months, how often have you been dizzy?” Wave V asked participants, aged 32-42 in 2016-2018 (n=12,300), who had been in Waves I and II, additional questions on prior BDP history, symptoms and falls in the past 12 months. In Wave V most questions were answered via web-based or mailed questionnaires, but more detailed questions were asked via CAPI in subsample 2b (n=1,101). Multivariable logistic regression analyses were used to estimate odds ratios [OR, 95% confidence intervals (CI)] for associations between BDP and falls.
Results: BDP prevalence past 12 months was 39.1% at Wave I (mean age=15.6 years), 42.1% at Wave II (mean=16.2 years) and 30.6% at Wave V (mean=37.5 years). BDP symptoms that bothered most were: light-headedness (29%), vertigo (21%), and presyncope (15%). Falling prevalence was 26.2%. Wave V multivariable models included age, sex, race/ethnicity, head trauma, headache, and tinnitus. Significant associations with BDP were female sex (OR=2.1; 95% CI: 1.9-2.4), head trauma (OR=2.2; CI: 1.8-2.7), headaches (OR=2.8; CI: 2.5-3.8), and tinnitus (OR=3.2; CI: 2.6-3.8). After adjusting for age, sex, and race/ethnicity, BDP was significantly associated with increased risk of falls (OR=3.0; CI: 2.6-3.4). From Wave V, prior history of BDP was: 8.4% age <18; 10.8% age 18-24; 13.3% age 25-29; 16.3% age 30-34; and 18.3% age ≥35 years. BDP was associated with standing up (58%), headaches (42%), bending over (40%), quick head movement (31%), and tinnitus (25%).
Conclusion: BDP affects all ages and is associated with increased risk of falls. BDP risk factors and sequela should be evaluated in future Add Health waves as this U.S. cohort ages.