Background
Methods
Study design and participants
Definition of dizziness
Detecting the associated factors
Statistical analysis
Results
Prevalence of dizziness
Entire cohort (n = 4,147 c) | Dizziness (n = 1,102 c) | |||||
---|---|---|---|---|---|---|
Weighted frequency percent (SE) / Weighted means (SE) | Weighted frequency percent (SE) / Weighted means (SE) | |||||
Dizziness (n = 1,102 c) | Non-dizziness (n = 3,045 c) | p | Chronic dizziness (n = 210 c) | Episodic dizziness (n = 892 c) | p | |
Demographic data | ||||||
Age b | < .001 | .043 | ||||
40–49 | 24.5 (1.9) | 29.8 (1.4) | 18.6 (3.8) | 25.7 (2.1) | ||
50–59 | 27.3 (1.9) | 31.2 (1.2) | 23.5 (4.6) | 28.1 (2.0) | ||
60–69 | 21.5 (1.4) | 22.3 (1.1) | 20.7 (3.9) | 21.6 (1.4) | ||
70–79 | 17.7 (1.3) | 12.1 (0.8) | 22.3 (3.3) | 16.7 (1.3) | ||
≥ 80 | 9.1 (1.0) | 4.7 (0.5) | 14.8 (2.5) | 7.9 (1.1) | ||
Sex b | < .001 | .034 | ||||
Male | 36.9 (1.5) | 51.4 (0.9) | 29.2 (3.5) | 38.5 (1.8) | ||
Female | 63.1 (1.5) | 48.6 (0.9) | 70.8 (3.5) | 61.5 (1.8) | ||
Household income b | < .001 | .027 | ||||
Lower | 26.2 (2.1) | 16.0 (1.2) | 35.9 (4.0) | 24.1 (2.4) | ||
Lower-middle | 24.5 (1.7) | 22.4 (1.3) | 27.8 (4.3) | 23.8 (1.7) | ||
Upper-middle | 25.3 (1.9) | 29.2 (1.3) | 14.9 (3.9) | 27.5 (2.1) | ||
Upper | 24.1 (2.0) | 32.4 (1.9) | 21.4 (5.3) | 24.6 (2.0) | ||
Education b | < .001 | .146 | ||||
Elementary school and below | 25.0 (1.9) | 15.2 (1.0) | 32.4 (4.9) | 23.7 (2.0) | ||
Middle school | 12.4 (1.1) | 10.7 (0.7) | 14.3 (2.9) | 12.0 (1.3) | ||
High school | 31.8 (1.8) | 36.3 (1.4) | 30.5 (4.3) | 32.1 (2.0) | ||
University or above | 30.8 (2.3) | 37.7 (1.9) | 22.8 (5.0) | 32.2 (2.4) | ||
Otologic examination | ||||||
Tympanic abnormality b | 6.7 (0.8) | 6.4 (0.5) | .741 | 10.1 (2.3) | 6.0 (0.8) | .037 |
Physical examination | ||||||
waist circumference b | .346 | .668 | ||||
<cut off | 45.9 (1.9) | 47.9 (1.1) | 47.5 (4.3) | 45.5 (2.0) | ||
≥cut off | 54.1 (1.9) | 52.1 (1.1) | 52.5 (4.3) | 54.5 (2.0) | ||
Serum TG level b | .026 | .340 | ||||
<150mg/dL | 71.5 (1.9) | 66.6 (1.1) | 75.0 (4.0) | 70.8 (2.0) | ||
≥150mg/dL | 28.5 (1.9) | 33.4 (1.1) | 25.0 (4.0) | 29.2 (2.0) | ||
Serum HDL level b | .230 | .616 | ||||
>cut off | 62.5 (1.8) | 64.9 (1.2) | 60.6 (4.3) | 62.9 (2.0) | ||
≤cut off | 37.5 (1.8) | 35.1 (1.2) | 39.4 (4.3) | 37.1 (2.0) | ||
Comorbidity | ||||||
Hypertension b | 34.5 (1.7) | 29.8 (1.0) | .007 | 43.5 (3.7) | 32.6 (1.9) | .008 |
Diabetes b | 13.2 (1.3) | 13.7 (0.7) | .720 | 22.3 (3.3) | 11.3 (1.2) | < .001 |
Stroke b | 3.4 (0.6) | 2.2 (0.3) | .074 | 4.7 (1.7) | 3.1 (0.6) | .289 |
Myocardial infarction b | 4.3 (0.6) | 3.3 (0.4) | .142 | 5.9 (1.6) | 4.0 (0.6) | .224 |
Arthritis b | 22.1 (1.5) | 11.7 (0.6) | < .001 | 32.8 (3.7) | 20.2 (1.7) | .002 |
Health behavior | ||||||
Smoking b | < .001 | .349 | ||||
Never smoker | 62.9 (1.8) | 55.4 (1.0) | 68.2 (3.5) | 61.8 (2.0) | ||
Former | 22.9 (1.3) | 26.6 (0.9) | 18.9 (3.1) | 23.8 (1.4) | ||
Current | 14.2 (1.3) | 17.9 (1.0) | 12.9 (3.0) | 14.5 (1.5) | ||
Alcohol consumption, more than once per month b | 48.5 (2.0) | 57.7 (1.2) | < .001 | 43.6 (4.9) | 49.5 (2.1) | .269 |
Sleep hours (4,139) b | .002 | < .001 | ||||
≤5 hr | 23.9 (1.4) | 18.0 (0.7) | 31.6 (3.5) | 22.3 (1.5) | ||
≤ 6 hr | 22.3 (1.4) | 25.7 (1.0) | 13.8 (2.4) | 24.0 (1.5) | ||
≤ 7 hr | 23.8 (1.6) | 27.8 (1.1) | 14.0 (3.1) | 25.8 (1.7) | ||
≤8 hr | 17.2 (1.4) | 16.4 (0.8) | 15.7 (3.7) | 17.5 (1.6) | ||
≥9 hr | 12.9 (1.4) | 12.2 (0.8) | 25.0 (3.8) | 10.5 (1.3) | ||
Functional status | ||||||
Limited functional status due to visual acuity b | < .001 | .084 | ||||
No limitation | 87.7 (1.0) | 94.3 (0.5) | 81.9 (3.1) | 88.7 (1.1) | ||
Limitation due to visual acuity | 0.5 (0.2) | 0.3 (0.1) | 1.0 (1.0) | 0.4 (0.2) | ||
Limitation but no due to visual acuity | 11.8 (1.0) | 5.4 (0.4) | 17.1 (2.8) | 10.8 (1.1) | ||
Activity of daily living b | < .001 | .008 | ||||
No difficulty with ADL | 88.4 (1.1) | 95.6 (0.5) | 80.7 (3.3) | 89.7 (1.2) | ||
Partial difficulty with ADL | 10.9 (1.0) | 4.2 (0.5) | 17.6 (3.1) | 9.7 (1.1) | ||
Cannot perform ADL | 0.7 (0.3) | 0.2 (0.1) | 1.7 (1.0) | 0.6 (0.3) | ||
Psychological variable | ||||||
Stress b | < .001 | .003 | ||||
None | 13.1 (1.2) | 16.7 (0.9) | 9.4 (1.9) | 13.9 (1.4) | ||
Little | 55.7 (1.5) | 60.8 (1.0) | 47.0 (3.4) | 57.5 (1.8) | ||
Much | 26.5 (1.6) | 18.5 (1.0) | 36.5 (3.9) | 24.4 (1.8) | ||
Very much | 4.7 (0.7) | 3.9 (0.5) | 7.1 (2.0) | 4.2 (0.7) | ||
Anxiety/Depression b | < .001 | .160 | ||||
None | 84.0 (1.4) | 93.2 (0.6) | 81.0 (3.4) | 84.5 (1.5) | ||
Much | 15.0 (1.3) | 6.5 (0.6) | 16.7 (3.3) | 14.8 (1.5) | ||
Very much | 1.0 (0.3) | 0.4 (0.1) | 2.4 (1.2) | 0.7 (0.3) | ||
Depression (PHQ-9 total score) a | 3.11 (0.16) | 1.79 (0.08) | < .001 | 5.02 (0.04) | 2.79 (0.16) | < .001 |
Cognitive/affective domain a,d | 0.24 (0.02) | 0.13 (0.01) | < .001 | 0.37 (0.05) | 0.22 (0.02) | .004 |
Somatic domain a,d | 0.48 (0.02) | 0.29 (0.01) | < .001 | 0.80 (0.06) | 0.43 (0.02) | < .001 |
Factors associated with dizziness
Univariable analysis | Multivariable analysis | |||
---|---|---|---|---|
OR (95% CI) | p | OR (95% CI) | p | |
Demographic data | ||||
Age | ||||
40–49 | 1 | 1 | ||
50–59 | 1.07 (0.83–1.38) | 0.612 | 1.06 (0.79–1.43) | 0.685 |
60–69 | 1.17 (0.92–1.49) | 0.186 | 0.98 (0.74–1.31) | 0.890 |
70–79 | 1.79 (1.40–2.28) | < 0.001 | 1.29 (0.84–1.99) | 0.235 |
≥ 80 | 2.36 (1.71–3.25) | < 0.001 | 1.43 (0.77–2.64) | 0.257 |
Sex | ||||
Male | 1 | 1 | ||
Female | 1.81 (1.54–2.13) | < 0.001 | 1.79 (1.34–2.39) | < 0.001 |
Household income | ||||
Lower | 2.21 (1.73–2.81) | < 0.001 | 1.09 (0.75–1.58) | 0.666 |
Lower-middle | 1.47 (1.20–1.81) | < 0.001 | 1.05 (0.81–1.36) | 0.726 |
Upper-middle | 1.17 (0.95–1.44) | 0.133 | 0.95 (0.77–1.18) | 0.667 |
Upper | 1 | 1 | ||
Education | ||||
Elementary school and below | 2.01 (1.63–2.48) | < 0.001 | 1.24 (0.86–1.79) | 0.239 |
Middle school | 1.41 (1.10–1.81) | 0.007 | 1.2 (0.83–1.74) | 0.333 |
High school | 1.07 (0.86–1.34) | 0.522 | 1 (0.77–1.29) | 0.973 |
University or above | 1 | 1 | ||
Otologic examination | ||||
Tympanic abnormality | 1.05 (0.77–1.43) | 0.741 | - | - |
Physical examination | ||||
waist circumference | ||||
<cut off | 1 | - | - | |
≥cut off | 1.08 (0.92–1.28) | 0.346 | - | - |
Serum TG level | ||||
<150 mg/dL | 1 | 1 | ||
≥150 mg/dL | 0.79 (0.65–0.97) | 0.026 | 0.92 (0.73–1.15) | 0.443 |
Serum HDL level | ||||
>cut off | 1 | - | - | |
≤cut off | 1.11 (0.94–1.32) | 0.230 | - | - |
Comorbidity | ||||
Hypertension | 1.24 (1.06–1.44) | 0.007 | 1 (0.81–1.23) | 0.999 |
Diabetes | 0.96 (0.75–1.22) | 0.720 | - | - |
Stroke | 1.54 (0.95–2.49) | 0.077 | - | - |
Myocardial infarction | 1.32 (0.91–1.91) | 0.144 | - | - |
Arthritis | 2.14 (1.75–2.62) | < 0.001 | 1.34 (0.98–1.82) | 0.065 |
Health behavior | ||||
Smoking b | ||||
Never smoker | 1 | 1 | ||
Former | 0.76 (0.63–0.91) | 0.003 | 1.33 (0.98–1.81) | 0.063 |
Current | 0.70 (0.55–0.89) | 0.004 | 1.24 (0.86–1.79) | 0.250 |
Alcohol consumption, more than once per month | 0.69 (0.57–0.83) | < 0.001 | 0.85 (0.69–1.04) | 0.118 |
Sleep hours | ||||
≤5 h | 1.55 (1.23–1.96) | < 0.001 | 1.05 (0.78–1.42) | 0.733 |
≤ 6 h | 1.01 (0.80–1.29) | 0.918 | 0.97 (0.73–1.27) | 0.797 |
≤ 7 h | 1 | 1 | ||
≤8 h | 1.23 (0.93–1.62) | 0.145 | 1.29 (0.94–1.75) | 0.109 |
≥9 h | 1.23 (0.92–1.66) | 0.165 | 0.75 (0.45–1.28) | 0.290 |
Functional status | ||||
Limited functional status due to visual acuity | ||||
No limitation | 1 | 1 | ||
Limitation due to visual acuity | 1.73 (0.51–5.83) | 0.373 | 0.54 (0.13–2.3) | 0.401 |
Limitation but no due to visual acuity | 2.34 (1.87–2.93) | < 0.001 | 1.19 (0.83–1.69) | 0.345 |
Activity of daily living | ||||
No difficulties in ADL | 1 | 1 | ||
Partial difficulties in ADL | 2.81 (2.11–3.75) | 0.030 | 1.29 (0.81–2.03) | 0.278 |
Cannot do ADL | 3.51 (1.13–10.89) | < 0.001 | 1.76 (0.34–9.21) | 0.501 |
Psychological variable | ||||
Stress | ||||
None | 1 | 1 | ||
Little | 1.17 (0.93–1.46) | 0.173 | 1.48 (1.09–2.01) | 0.014 |
Much | 1.83 (1.40–2.39) | < 0.001 | 1.99 (1.4–2.85) | < 0.001 |
Very much | 1.53 (1.01–2.31) | 0.044 | 1.14 (0.69–1.9) | 0.599 |
Anxiety/Depression | ||||
None | 1 | 1 | ||
Much | 2.58 (1.97–3.37) | <,001 | 1.26 (0.88–1.81) | 0.209 |
Very much | 3.00 (1.16–7.76) | 0.024 | 0.74 (0.19–2.92) | 0.660 |
Depression (PHQ-9 total score) | 1.11 (1.08–1.14) | < 0.001 | 1.08 (1.04–1.12) | < 0.001 |
Male | Female | |||
---|---|---|---|---|
OR (95% CI) | p | OR (95% CI) | p | |
Demographic data | ||||
Age | ||||
40–49 | 1 | 1 | ||
50–59 | 0.96 (0.62–1.49) | 0.870 | 1.18 (0.8–1.74) | 0.392 |
60–69 | 0.96 (0.59–1.56) | 0.877 | 0.94 (0.63–1.41) | 0.781 |
70–79 | 2.04 (1.14–3.63) | 0.016 | 0.67 (0.37–1.23) | 0.197 |
≥ 80 | 2.29 (1.03–5.06) | 0.041 | 0.74 (0.28–1.95) | 0.542 |
Household income | ||||
Lower | 1.13 (0.67–1.91) | 0.655 | 0.98 (0.59–1.62) | 0.930 |
Lower-middle | 0.92 (0.59–1.45) | 0.731 | 1.11 (0.77–1.6) | 0.579 |
Upper-middle | 0.93 (0.63–1.35) | 0.687 | 0.96 (0.7–1.32) | 0.818 |
Upper | 1 | 1 | ||
Education | ||||
Elementary school and below | 1.28 (0.75–2.18) | 0.368 | 1.39 (0.8–2.4) | 0.239 |
Middle school | 1.83 (1.05–3.17) | 0.032 | 0.82 (0.52–1.29) | 0.380 |
High school | 1.32 (0.93–1.87) | 0.124 | 0.75 (0.53–1.07) | 0.110 |
University or above | 1 | 1 | ||
Physical examination | ||||
Serum TG level | ||||
<150 mg/dL | 1 | 1 | ||
≥150 mg/dL | 1.01 (0.74–1.4) | 0.929 | 0.87 (0.62–1.23) | 0.430 |
Comorbidity | ||||
Hypertension | 0.92 (0.66–1.28) | 0.615 | 1.11 (0.83–1.5) | 0.474 |
Arthritis | 1.27 (0.69–2.35) | 0.436 | 1.59 (1.12–2.27) | 0.010 |
Health behavior | ||||
Smoking | ||||
Never smoker | 1 | 1 | ||
Former | 1.25 (0.81–1.92) | 0.317 | 1.15 (0.68–1.93) | 0.601 |
Current | 1.09 (0.66–1.81) | 0.727 | 1.81 (1.03–3.17) | 0.040 |
Alcohol consumption, more than once per month | 0.71 (0.51–0.99) | 0.042 | 0.95 (0.73–1.25) | 0.738 |
Sleep hours | ||||
≤5 h | 0.82 (0.53–1.28) | 0.392 | 1.32 (0.94–1.85) | 0.113 |
≤ 6 h | 0.89 (0.56–1.41) | 0.610 | 1.04 (0.74–1.48) | 0.815 |
≤ 7 h | 1 | 1 | ||
≤8 h | 1.09 (0.67–1.78) | 0.725 | 1.4 (0.95–2.07) | 0.088 |
≥9 h | 0.72 (0.34–1.53) | 0.395 | 0.68 (0.32–1.41) | 0.295 |
Functional status | ||||
Limited functional status due to visual acuity | ||||
No limitation | 1 | 1 | ||
Limitation due to visual acuity | 0.49 (0.05–5.05) | 0.551 | 0.38 (0.06–2.45) | 0.308 |
Limitation but no due to visual acuity | 1.29 (0.75–2.21) | 0.352 | 1.12 (0.66–1.88) | 0.677 |
Activity of daily living | ||||
No difficulties in ADL | 1 | 1 | ||
Partial difficulties in ADL | 1.73 (0.92–3.25) | 0.088 | 0.88 (0.49–1.56) | 0.658 |
Cannot do ADL | 1.87 (0.16–21.16) | 0.613 | 0.76 (0.08–7.55) | 0.811 |
Psychological variable | ||||
Stress | ||||
None | 1 | 1 | ||
Little | 1.39 (0.84–2.32) | 0.201 | 1.59 (1.06–2.39) | 0.027 |
Much | 2.19 (1.24–3.87) | 0.007 | 1.97 (1.25–3.09) | 0.003 |
Very much | 1.51 (0.63–3.61) | 0.351 | 0.97 (0.5–1.89) | 0.924 |
Anxiety/Depression | ||||
None | 1 | |||
Much | 1.29 (0.74–2.23) | 0.364 | 1.31 (0.86–1.97) | 0.205 |
Very much | 0.37 (0.03–5.32) | 0.464 | 1.49 (0.32-7) | 0.612 |
Depression (PHQ-9 total score) | 1.1 (1.04–1.16) | 0.001 | 1.07 (1.02–1.12) | 0.004 |
Factors associated with chronic dizziness
Univariable analysis | Multivariable analysis | |||
---|---|---|---|---|
OR (95% CI) | p | OR (95% CI) | p | |
Demographic data | ||||
Age | ||||
40–49 | 1 | 1 | ||
50–59 | 1.15 (0.60–2.21) | 0.673 | 1.19 (0.58–2.42) | 0.638 |
60–69 | 1.32 (0.68–2.57) | 0.409 | 1.14 (0.54–2.4) | 0.727 |
70–79 | 1.84 (1.00-3.39) | 0.050 | 1.45 (0.65–3.25) | 0.364 |
≥ 80 | 2.58 (1.35–4.94) | 0.004 | 1.55 (0.61–3.9) | 0.353 |
Sex | ||||
Male | 1 | 1 | ||
Female | 1.51 (1.03–2.22) | 0.034 | 1.28 (0.83–1.99) | 0.262 |
Household income | ||||
Lower | 1.72 (0.89–3.31) | 0.107 | - | - |
Lower-middle | 1.35 (0.68–2.68) | 0.396 | - | - |
Upper-middle | 0.63 (0.27–1.47) | 0.279 | - | - |
Upper | 1 | - | - | |
Education | ||||
Elementary school and below | 1.94 (1.05–3.58) | 0.035 | 1.01 (0.46–2.21) | 0.989 |
Middle school | 1.68 (0.80–3.55) | 0.172 | 1.01 (0.44–2.3) | 0.983 |
High school | 1.35 (0.71–2.56) | 0.360 | 0.97 (0.49–1.91) | 0.925 |
University or above | 1 | 1 | ||
Otologic examination | ||||
Tympanic abnormality | 1.76 (1.03-3.00) | 0.038 | 2.08 (1.07–4.04) | 0.030 |
Physical examination | ||||
waist circumference | ||||
<cut off | 1 | - | - | |
≥cut off | 0.93 (0.65–1.32) | 0.668 | - | - |
Serum TG level | ||||
<150 mg/dL | 1 | - | - | |
≥150 mg/dL | 0.81 (0.52–1.25) | 0.340 | - | - |
Serum HDL level | ||||
>cut off | 1 | - | - | |
≤cut off | 1.10 (0.75–1.63) | 0.616 | - | - |
Comorbidity | ||||
Hypertension | 1.59 (1.13–2.24) | 0.008 | 1.19 (0.76–1.87) | 0.440 |
Diabetes | 2.25 (1.49–3.41) | < 0.001 | 2.4 (1.44–4.02) | 0.001 |
Stroke | 1.51 (0.70–3.27) | 0.292 | - | - |
Myocardial infarction | 1.52 (0.77–2.98) | 0.225 | - | - |
Arthritis | 1.92 (1.27–2.91) | 0.002 | 1.26 (0.76–2.11) | 0.373 |
Health behavior | ||||
Smoking | ||||
Never smoker | 1 | - | - | |
Former | 0.72 (0.46–1.12) | 0.141 | - | - |
Current | 0.81 (0.45–1.46) | 0.481 | - | - |
Alcohol consumption, more than once per month | 0.79 (0.52–1.20) | 0.269 | - | - |
Sleep hours | ||||
≤5 h | 2.62 (1.58–4.34) | < 0.001 | 1.92 (1.03–3.58) | 0.040 |
≤ 6 h | 1.06 (0.58–1.91) | 0.857 | 1.03 (0.54–1.96) | 0.923 |
≤ 7 h | 1 | 1 | ||
≤8 h | 1.65 (0.74–3.67) | 0.221 | 1.6 (0.71–3.59) | 0.255 |
≥9 h | 4.40 (2.27–8.55) | < 0.001 | 0.74 (0.22–2.48) | 0.624 |
Functional status | ||||
Limited functional status due to visual acuity | ||||
No limitation | 1 | 1 | ||
Limitation due to visual acuity | 2.59 (0.2923.32) | 0.394 | 0.94 (0.16–5.48) | 0.948 |
Limitation but no due to visual acuity | 1.71 (1.07–2.74) | 0.026 | 0.76 (0.41–1.4) | 0.375 |
Activity of daily living | ||||
No difficulties in ADL | 1 | 1 | ||
Partial difficulties in ADL | 2.01 (1.22–3.33) | 0.007 | 1.17 (0.62–2.2) | 0.621 |
Cannot do ADL | 3.29 (0.70–5.43) | 0.130 | 0.67 (0.09–5.04) | 0.694 |
Psychological variable | ||||
Stress | ||||
None | 1 | 1 | ||
Little | 1.21 (0.73-2.00) | 0.465 | 1.41 (0.77–2.58) | 0.263 |
Much | 2.21 (1.22–4.01) | 0.009 | 2.31 (1.14–4.68) | 0.021 |
Very much | 2.49 (1.06–5.86) | 0.037 | 2.12 (0.7–6.48) | 0.185 |
Anxiety/Depression | ||||
None | 1 | - | - | |
Much | 1.18 (0.71–1.96) | 0.524 | - | - |
Very much | 3.36 (0.9112.49) | 0.070 | - | - |
Depression (PHQ-9 total score) | 1.11 (1.07–1.15) | < 0.001 | 1.07 (1.02–1.12) | 0.003 |