Impact of Balance and Dizziness Problems on Falls in Older Adults: The Longitudinal AGES ‐Reykjavik Study

Objective To investigate the impact of balance and dizziness problems (BDP) and other risk factors on falls in a longitudinal, population‐based cohort of older adults. Methods The Age, Gene/Environment Susceptibility‐Reykjavik Study (AGES‐RS I) 2002–2006 examined 5764 adults aged 66–98. Five years later, 3316 surviving subjects were reexamined in AGES‐RS II. Participants were asked about BDP, falls, usual activities, and health conditions. BDP symptoms during the past 12 months included: vertigo (spinning/moving sensation); floating/spacey sensation; light‐headedness (no moving sensation); near fainting (presyncope) or fainting (syncope); blurred vision with head movement (oscillopsia); and feeling off‐balance/unsteady. Clinical assessments included hand grip and leg strength plus steps and time to walk 6 m. Results During the past 12 months in AGES‐RS II, BDP prevalence was 40.1% (males 35.2%, females 43.7%) and the prevalence of falling was 23.0% (males 20.9%, females 24.8%). BDP increased steps and time to walk 6 m. BDP increased the risk of falls (adjusted prevalence ratio [PR] = 1.53; 95% confidence interval [CI]: 1.34–1.76 for AGES‐RS I, PR = 1.77, 95% CI: 1.55–2.03 for AGES‐RS II). The prevalence of ≥ 2 falls was 8.9% (15.6% with BDP vs. 4.4% without BDP). Among those who fell ≥ 2 times, 70.4% reported BDP in the past 12 months. Additional risk of falling was associated with fear/panic attacks, memory loss, hearing loss, and other health conditions. Conclusion BDP are common in older adults and associated with 50% to 80% increased risk of falling and even greater risk of falling ≥ 2 times. Quantitative estimates are provided for contributing factors that further increase the risk of falls. Level of Evidence 2 (prospective cohort study).