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.
