Gesundheitswesen 2017; 79(08/09): 656-804
DOI: 10.1055/s-0037-1605740
Vorträge
Georg Thieme Verlag KG Stuttgart · New York

Anticholinergic and sedative medication as risk factor for vertigo and dizziness in the general population: Results from the KORA-FF4 survey

A Phillips
1   Ludwig-Maximilians-Universität, German Center for Vertigo and Balance Disorders, Munich
2   Ludwig-Maximilians-Universität, Institute for Medical Information Processing, Biometrics and Epidemiology, Munich
,
M Heier
3   Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg
,
R Strobl
1   Ludwig-Maximilians-Universität, German Center for Vertigo and Balance Disorders, Munich
2   Ludwig-Maximilians-Universität, Institute for Medical Information Processing, Biometrics and Epidemiology, Munich
,
B Linkohr
3   Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg
,
R Holle
4   Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg
,
A Peters
3   Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg
,
E Grill
1   Ludwig-Maximilians-Universität, German Center for Vertigo and Balance Disorders, Munich
2   Ludwig-Maximilians-Universität, Institute for Medical Information Processing, Biometrics and Epidemiology, Munich
› Author Affiliations
Further Information

Publication History

Publication Date:
01 September 2017 (online)

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Introduction:

Vertigo and dizziness are common syndromes with a high potential for adverse outcomes. Inappropriate medication is one of the many risk factors causing vertigo and dizziness in adults. Specifically drugs with anticholinergic and sedative effects (AS) may have this effect. The Drug Burden Index (DBI) is a novel approach to measure the cumulative exposure to AS medication and its burden on vertiginous syndromes.

Methods:

Data originates from the second follow-up (FF4) in 2013/14 of the Cooperative Health Research in the Region of Augsburg (KORA)-S4 study (1999 – 2001) from Southern Germany. To assess AS exposure, a DBI score was calculated for all participants regarding ingested medications, which were utilized regularly. Exposure to AS medication was classified as DBI > 0. Cases were defined as participants who reported moderate or severe vertigo during the last 12 months and those who reported no vertigo as controls. Logistic regression controlled for age, sex, comorbidities, and life style factors was used to estimate the association of AS medication and vertigo.

Results:

A total of 2279 participants (570 cases, 1709 controls) were included in this study (51.7% female, mean age = 60.8, SD = 12.4). AS exposure was present in 229 (10.1%) participants. Prevalence of AS exposure increased with age among cases (4.3% in those ≤48 years, to 23.5% in those ≥69 years) and controls (3.9% to 12.2%, respectively). Exposure to AS medication (adjusted odds ratio aOR 1.58; 95% confidence interval CI, 1.14 – 2.16), female sex (aOR 1.63, CI 1.29 – 2.08), falls (aOR 2.14, CI 1.63 – 2.80) and depression (aOR 3.16, CI 1.71 – 5.84) were independently associated with vertigo.

Conclusion:

This is the first study providing reliable estimates of the prevalence of exposure to

AS medication in adults using the DBI in Germany, also indicating an association with vertigo. Caution should be taken when prescribing AS medications, and doctors should consider reviewing the AS burden.