Fall Injury Prevention Through Appropriate Screening

Dizziness and vertigo are with the leading three reasons why patients visit a physician. Back pain and headaches comprise the other two reasons. Symptoms including dizziness, vertigo and imbalance actually are estimated to affect 40% of patients 40 years of age and older. Of those age 65 years or older, 25% are estimated to incur a fall and thus a fall related injury. Falling is typically a direct consequence of dizziness, primarily in this group of the elderly and risk of falling can rise considerably when those patients have other problems such as hypertension or diabetes, or any of the gamut of neurologic defects such as Parkinson’s. A sample report of US emergency room visits, from 1995-2004, confirmed that vertigo and dizziness were in fact elevated on the list of reported presenting complaints as reason for reporting to the hospital. Information from the National Health and Nutrition Examination Survey demonstrated that individuals with symptomatic vestibular dysfunction have a twelve-fold rise in the likelyhood of incurring a fall.

It has also been shown that more frequent medical consultation, sick leave, and disruption of daily activities in general, have been related to dizziness symptoms, particularly vestibular vertigo.

Medical research on disorders is commonly disease oriented as opposed to symptoms related. This generalized approach may actually underestimate the reality of such common symptoms as vertigo and dizziness, which as mentioned, rank high as patient complaints in primary care, yet evade accurate diagnosis and remain unexplained in eighty% of cases. Making situations worse, even though symptoms of vertigo and dizziness can be associated with a wide variety of other disorders, all of which necessitate a multidisciplinary approach to management, said dizziness symptoms infrequently prompt appropriate referral to a qualified specialist for proper examination. The most frequent conditions which cause such symptoms as vertigo and dizziness for the most part remain largely undiagnosed outside of specialty clinics such as my own.

Because of the substantial possibility of injury and the resultant decline in independence and/or quality of life following a fall, knowing who is at risk is most helpful, and for individuals who lessen that risk through a fall prevention program such as ours, falls and otherwise impending fall related injuries could be diverted. Our office does just that using computerized technology, which oddly, only takes seconds to perform. Balance is not a single physiologic function. The sensory inputs for balance include vision, vestibular, and proprioceptive feedback. When an individual is walking, the brain must immediately assimilate this information and orchestrate appropriate motor planning.

This function must be supported by an adequate neuromusculoskeletal system. All of these factors change with age. Further, any disease related decline in any of these systems further impairs balance. Bilateral vestibular loss is a significant contributor in 25% of elderly patients with imbalance. Unmanaged vertigo is an elevated risk factor for falling as well.

Our office, as a community service, does not charge for balance/risk-of-fall analysis. Call my clinic (below) to be screened.

Jersey Shore Regional Center for Vertigo, Dizziness, Dystonia and ADD ADHD. Visit Dr. Scopelliti’s Guestbook to see what patients say. Dr. Scopelliti is board certified in Neurology & Vestibular Rehabilitation and is an author/lecturer of postdoctoral neurology. Specialties: vertigo, dizziness, imbalance, presyncope, dystonia, ADD ADHD, coma & neurologic/behavioral/cognitive disorders.