Evaluation of balance disorders

Balance disorders are common and may significantly impact upon quality of life and independence. Impaired balance may result in falls with resulting morbidity and mortality, particularly in older people.

Epidemiology

Estimates of dizziness and vertigo in the community range from 17% to 30% and from 3% to 10%, respectively.[1]Murdin L, Schilder AG. Epidemiology of balance symptoms and disorders in the community: a systematic review. Otol Neurotol. 2015 Mar;36(3):387-92. http://www.ncbi.nlm.nih.gov/pubmed/25548891?tool=bestpractice.com The prevalence of balance problems at age 70 years is reported to be 36% in women and 29% in men.[2]Jonsson R, Sixt E, Landahl S, et al. Prevalence of dizziness and vertigo in an urban elderly population. J Vestib Res. 2004;14(1):47-52. http://www.ncbi.nlm.nih.gov/pubmed/15156096?tool=bestpractice.com

Symptoms of dizziness or vertigo may constitute between 1% and 15.5% of primary care consultations.[3]Bösner S, Schwarm S, Grevenrath P, et al. Prevalence, aetiologies and prognosis of the symptom dizziness in primary care - a systematic review. BMC Fam Pract. 2018 Feb 20;19(1):33. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5819275 http://www.ncbi.nlm.nih.gov/pubmed/29458336?tool=bestpractice.com Among the most commonly reported etiologies in primary care are vestibular/peripheral (5.4% to 42.1%), benign paroxysmal positional vertigo (4.3% to 39.5%), cardiovascular disease (3.8% to 56.8%), psychogenic (1.8% to 21.6%), Menière disease (1.4% to 2.7%), neurologic disease (1.4% to 11.4%) vestibular neuritis (0.6% to 24%), and no clear diagnosis (up to 80.2%).[3]Bösner S, Schwarm S, Grevenrath P, et al. Prevalence, aetiologies and prognosis of the symptom dizziness in primary care - a systematic review. BMC Fam Pract. 2018 Feb 20;19(1):33. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5819275 http://www.ncbi.nlm.nih.gov/pubmed/29458336?tool=bestpractice.com