PP1405 - Association Between Self-Reported Dizziness Handicap and Computerized Dynamic Posturography Performance

Abstract:
Dizziness is a common health concern, affecting over 30% of American older adults (Fancello et al., 2023). In addition to diagnostic measures, audiologists can also assess the impact of dizziness on the patient using a subjective questionnaire such as the Dizziness Handicap Inventory (DHI) (Jacobsen et al., 1991) and/or an objective assessment such as Computerized Dynamic Posturography (CDP) (Vanicek et al., 2013). Although both tools assess functional components of dizziness, there is limited research evaluating the relationship between these measures. The present retrospective study aims to assess the association between patient DHI scores and CDP performance.

Summary
Dizziness is one of the most common medical complaints, affecting over 30% of older adults in the United States (Fancello et al., 2023). However, dizziness is a broad term that can encompass many patient percepts, including vertigo, spinning, unsteadiness, or lightheadedness, to name a few (Zamyslowska-Szmytke et al., 2021). Audiologists can evaluate patients’ dizziness in several ways. In addition to determining the etiology of dizziness and the objective severity of the disorder, it is also crucial for audiologists to evaluate the impact of the disorder on the patient. One commonly used way to evaluate this is by using a subjective questionnaire such as the Dizziness Handicap Inventory (DHI), which was developed to evaluate self-perceived handicap of disorders of the balance system (Jacobsen et al., 1991) by examining the impact of dizziness on the physical, emotional, and functional aspects of daily life (Clendaniel, 2000). Another method to evaluate the effects of a patient’s dizziness is through Computerized Dynamic Posturography (CDP), a clinical assessment tool used to objectively measure postural control and quantify functional contributions of the somatosensory, visual, and vestibular systems in maintaining balance (Vanicek et al., 2013). The handicap and impacts of dizziness can vary greatly among patients, making assessments of this nature an important component of the vestibular test battery.

Although the DHI and CDP both evaluate the functional impacts of dizziness, there is limited research evaluating the relationship between these two measures. This is of interest as not every audiology practice is equipped with CDP systems due to barriers such as time, space, and cost. However, a subjective questionnaire such as the DHI can easily be administered to every patient. Thus, this study aims to assess the association between patients’ DHI scores and CDP performance to examine how these two test outcomes might be related. Additionally, patient demographics will also be explored within this context. In the present retrospective study, electronic medical records were searched to identify patients who were seen for full vestibular evaluations at the Mayo Clinic in Florida within the past two years. Adult patients (aged 18 and older) were included in the study if complete DHI and CDP data were available for review. If data were missing, patients were excluded from the study. Patient responses on the DHI were compared to their performance on Computerized Dynamic Posturography (CDP) assessments, particularly the Sensory Organization Test (SOT). Patient demographic characteristics such as age, gender, and diagnoses were also explored.

Functional measures are an important component to help determine the impact of dizziness on a patient’s quality of life. Findings regarding the association of the Dizziness Handicap Inventory and/or Computerized Dynamic Posturography may help guide clinicians in what functional measures to include in their vestibular diagnostic test battery.