Understanding Vestibular Vertigo: Symptoms, Risks, and Why Access to Care Matters

If you've been experiencing dizziness, feeling off-balance, or even true spinning sensations (vertigo), you're not alone. These symptoms are common and can significantly impact daily life.

What is Vestibular Vertigo?

Vestibular vertigo is a common inner ear problem that can manifest as a spinning or vertigo sensation, feeling off-balance or unsteady, or even blurring of your vision when you move your head. It can lead to diminished quality of life and may affect daily activities like driving.

Who is at Higher Risk?

Research indicates that certain groups have a higher likelihood of experiencing vestibular vertigo:

• Women are at a significantly higher risk of vestibular vertigo.
• Adults over 60 years of age also show a higher proportion of vestibular vertigo. Specifically, age groups like 40-49 and 60-64 have been associated with increased risk.

How Vestibular Physiotherapy Can Help:

The management of many causes of vestibular vertigo includes specialist care, such as vestibular physical therapy, along with follow-up care. This specialized therapy is crucial for addressing the condition and improving your symptoms. However, access to this care can sometimes be a challenge due to factors like cost. Addressing these barriers and ensuring access to appropriate specialist care, including vestibular physical therapy, is important for optimizing outcomes and improving patient care.

Let's delve deeper into the study we've been discussing, as it provides valuable insights into vestibular vertigo and access to care.

The information comes from a study titled "Vestibular Vertigo and Disparities in Healthcare Access among Adults in the United States" by Gun Min Youn, Jay P. Shah, Yuri Agrawal, and Eric X. Wei. This research was published in the journal Ear and Hearing in 2023.

Overview of the Study

The main goal of this study was to understand if there were differences in how easily adults with vestibular vertigo could access and afford medical care, especially considering factors like their race/ethnicity, income, and insurance status. The researchers wanted to identify any "health disparities," which are differences in health outcomes or access to care that are often linked to social or economic disadvantages.

How the Study Was Conducted

• Data Source: The study used information from the 2016 National Health Interview Survey (NHIS), which is an annual survey conducted by the Centers for Disease Control and Prevention (CDC). This survey collects a wide range of demographic, socioeconomic, and health information through face-to-face interviews in people's homes. The 2016 dataset was chosen specifically because it included an "Adult Balance Supplement" that asked questions about balance and dizziness problems.
• Participants: The researchers analyzed data from 32,047 adults who completed the 2016 NHIS Balance Supplement. Out of these, 4,793 participants (almost 15%) were identified as having vestibular vertigo.
• Defining Vestibular Vertigo: For this study, vestibular vertigo was carefully defined based on self-reported symptoms. It included individuals who experienced:

• Positional vertigo: Dizziness or balance problems triggered by looking up or down, leaning the head back or bending forward, or rolling over in bed.
• Rotational vertigo: Feeling a spinning or true vertigo sensation, or other illusions of motion like tipping, tilting, or rocking in the past 12 months.
• Recurrent dizziness: With nausea or vomiting, combined with either feeling off-balance or unsteady (imbalance), or blurring of vision when moving the head (oscillopsia).
• It's important to note that events where alcohol was involved were excluded. These definitions have been validated in previous studies for their accuracy.
• Factors Examined: The study looked at various demographic and socioeconomic characteristics of the participants, including age, sex, education level, race/ethnicity, family income, and type of insurance. They also accounted for other health conditions like diabetes, hypertension, and smoking status, as these can sometimes influence balance issues.
• Measuring Healthcare Access Barriers: The researchers assessed whether participants reported difficulties accessing care, such as:
  • Delaying or not receiving medical care due to worry about costs.
  • Delaying medical care due to lack of transportation.
  • Needing but not receiving prescription medicines, specialist care, or follow-up care due to costs.
  • Skipping medication doses, taking fewer medications, delaying filling prescriptions, or asking doctors for lower-cost medications to save money.

Key Findings from the Study The study found significant differences between people with and without vestibular vertigo. Specifically, those with vestibular vertigo were:

• More likely to be older than 60 years of age (43.88% vs. 34.58%).
• More likely to be female (68.06% vs. 52.16%).
• More likely to have medical conditions like diabetes and hypertension, and to be smokers.
• More frequently reported facing barriers in accessing care compared to individuals without vestibular vertigo. For example, they were more likely to report delaying medical care due to cost (17.7% vs. 14.1%), delaying care due to lack of transportation (7.5% vs. 1.4%), and being unable to afford specialist care (10.3% vs. 2.9%).

When looking at specific risk factors for developing vestibular vertigo, the study confirmed:

• Female sex was associated with significantly higher rates of vestibular vertigo (adjusted odds ratio [OR], 2.294). This means women were more than twice as likely to experience it compared to men.
• Certain older age groups were associated with a higher risk of vestibular vertigo, specifically the 40-49 age group (OR, 1.231) and the 60-64 age group (OR, 1.218) compared to the 18-29 age group.
• Individuals in higher income brackets had increasingly reduced risks of vestibular vertigo, suggesting that higher income can be a protective factor for overall health conditions, including vestibular issues.
• Having comorbidities like diabetes and hypertension, as well as smoking, were also associated with increased odds of vestibular vertigo.

Regarding healthcare access, the study concluded that race, income, and insurance status were significantly associated with barriers in accessing and affording care for individuals with vestibular vertigo. This highlights existing health disparities that need to be addressed in healthcare. The findings also indicated that uninsured and/or low-income individuals with vestibular vertigo had significant difficulty accessing specialty care and prescription medications.

How Vestibular Physiotherapy Can Help

The study itself emphasizes that the management of many causes of vestibular vertigo often includes specialist care, such as vestibular physical therapy, along with follow-up care. The findings about challenges in accessing specialist care due to cost or other barriers underscore the importance of ensuring that people can receive this crucial therapy. Vestibular physiotherapy can play a vital role in addressing symptoms like dizziness and imbalance, ultimately helping to improve your quality of life and reduce the impact of these conditions on your daily activities.

‍

Reference