Dizziness and Falls in Obese Inpatients Undergoing Metabolic Rehabilitation

Aim
The relationship between dizziness and falls in the obese population is a relatively unexplored issue. The aims of the present study were to define the 1-year prevalence of dizziness in an obese inpatient population undergoing metabolic rehabilitation and to investigate possible correlations with fall events.
Materials and Methods
We recruited 329 obese subjects: 203 female (BMI 43,74 kg/m2 ± 0.5 SE; age 17–83 years, 58.33 ± 0.9 SE) and 126 male (BMI 44,27kg/m2 ± 0.7 DE age 27–79 years, 58.84 ± 1 SE). To assess dizziness we used the validated Italian version (38) of the Dizziness Handicap Inventory (DHI).
Results
Out of the experimental sample, 100 subjects did not complain of dizziness and felt confident about their balance control, while 69.6% reported some degree of dizziness. Their mean DHI score was 22.3, which corresponds to mild dizziness. Twenty-one percent reported more severe dizziness (DHI score > 40). The majority of our sample reported minor dizziness and its perception appears to be independent from BMI: DHI scores were consistent across classes of obesity.
Discussion
The rate of dizziness and falls (30.1%) in an this obese population was higher than that previously reported in a general matched population. However, obese subjects, in our sample, seem to underestimate their risk of fall and DHI score does not appear a reliable predictor of falls. Since complications associated with falls in obese persons generally require longer treatments than in lean individuals, our findings should be taken into account in order to identify other predictors, including cognitive and perceptual, of risk of fall and to implement fall prevention programs.

研究目的
肥胖人群中头晕与跌倒的关联尚未得到充分探索。本研究旨在明确接受代谢康复治疗的肥胖住院患者群体的头晕1年患病率，并探究其与跌倒事件的潜在相关性。

材料与方法
本研究共纳入329例肥胖受试者：其中女性203例，体质量指数（Body Mass Index, BMI）为43.74 kg/m²±0.5标准误（Standard Error, SE），年龄17~83岁，平均年龄58.33±0.9 SE；男性126例，BMI为44.27 kg/m²±0.7 SE，年龄27~79岁，平均年龄58.84±1 SE。采用经过验证的意大利语版头晕残障量表（Dizziness Handicap Inventory, DHI）（文献38）评估受试者的头晕情况。

研究结果
本受试样本中，100例受试者无头晕主诉且自述平衡控制能力良好，另有69.6%的受试者存在不同程度的头晕症状。受试者的平均DHI得分为22.3，对应轻度头晕；21%的受试者头晕症状更为严重（DHI得分＞40）。本样本中多数受试者仅表现为轻度头晕，且头晕感知与BMI无明显关联：不同肥胖分级的受试者DHI得分均保持一致。

讨论
本肥胖人群中头晕与跌倒的共患率为30.1%，高于此前普通匹配人群的报道数据。然而本研究样本中的肥胖受试者似乎低估了自身的跌倒风险，且DHI得分并非跌倒风险的可靠预测因子。鉴于肥胖人群跌倒相关并发症的治疗周期通常长于体质量正常人群，本研究结果可为识别跌倒风险的其他预测因子（包括认知与感知相关因素）及制定跌倒预防方案提供参考。