Jasmine Menant – Abstract

P12  Balance in dizzy middle-aged and older people reporting unsteadiness: is it all in the head?

Menant JM[1], Brodie MA[1], Migliaccio A[1], Close J[1,2], Titov N[3], Delbaere K[1], Sturnieks D[1], Turner J[1] and Lord SR[1]

  1. Falls Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, Australia
  2. Prince of Wales Clinical School, UNSW, Sydney, NSW, 2031, Australia
  3. Department of Psychology, Macquarie University, Sydney, NSW, 2109, Australia

Anecdotally, self-reports of long-lasting unsteadiness among people with dizziness are often attributed to psychological causes. Here, we investigated balance during standing and walking in middle-aged and older dizzy people self-reporting unsteadiness lasting for hours to days. We conducted a secondary analysis of baseline data from a randomised controlled trial (1). Three hundred and five community-dwellers aged 50-92 years, reporting significant dizziness in the past year and not undergoing treatment completed questionnaires relating to dizziness history and psychological function and undertook tests of sensori-motor function, balance, stepping and gait. Based on self-reported dizziness history, we identified participants (n=65) who reported experiencing symptoms of constant imbalance, unsteadiness, “legs detached from the body”, “floating sensation” for at least one hour at the time. Compared with the rest of the dizzy sample (n=240), those self-reporting unsteadiness did not differ in age, general cognition, symptoms of anxiety, depression, neuroticism or fear of falling (p>0.05). However, participants with self-reported unsteadiness had increased postural sway during standing (eyes open / closed, on /off a compliant surface) compared with the rest of the dizzy sample (p<0.05 for all). They also displayed greater medio-lateral instability at the head and pelvis (smaller harmonic ratios recorded with 3D accelerometers) during walking (p0.05). In conclusion, contrary to common beliefs, middle-aged and older people self-reporting long lasting unsteadiness appear to have impaired balance during standing and walking, as indicated in quantitative assessments. 

  1. Menant JC & al (2018) Plos Med 15(7):e1002620