Table 3.

Abnormal Findings During the Examination of 417 Dizzy Elderly Patients in Primary Care

Examination by System	Findings	No.	%
ODS = oculi dexter et sinister; PRIME-MD = Primary Care Evaluation of Mental Disorders.
Note: For diagnostic criteria, see Supplemental Appendix 2, available at http://www.annfammed.org/cgi/content/full/8/3/196/DC1.
^a Not measured because of edema, severe obesity, or irregular pulse.
^b Not performed because of fear, pathology of neck or back, or other physical problems of the patient.
^c Unreliable test result because of suboptimal testing conditions during home visit.
^d An electrocardiogram was indicated if (1) a patient complained of presyncopal dizziness (a faint feeling, light-headedness, or a feeling of everything turning black), (2) palpitations were associated with dizziness, or (3) exercise provoked complaints of dizziness.
^e Continuous-loop event recording indicated if electrocardiogram did not show a clear explanation.
^f Questionnaire incomplete.
Physical examination
Cardiovascular system
Pulse	Bradycardia	23	6
	Tachycardia	1	0
	Irregular	50	12
Blood pressure	Systolic blood pressure ≥160 mm Hg	198	48
Orthostatic hypotension test	Positive, without reproduction of symptoms	43	10
	Positive, with reproduction of symptoms	58	14
	Unknown^a	5	1
Auscultation of the heart	Systolic/diastolic murmur without radiation	57	14
	Systolic/diastolic murmur with radiation	48	12
Locomotor system
Orthopedic screening	Limited stability at rest	193	46
	Limited stability during walking	177	42
	Limited mobility hip(s)	152	37
	Limited mobility knee(s)	105	25
	Limited mobility ankle(s)	50	12
Tandem gait	Tandem gait score ≥40	32	8
	Not possible, because of lack of stability	115	28
The timed up-and-go test	Abnormal (≥20 sec)	71	17
	Not possible, because of lack of stability	3	1
Neurological system
Tendon reflexes	Abnormal patellar tendon reflex	89	21
	Abnormal Achilles tendon reflex	68	16
	Abnormal plantar responses	9	2
Semmes-Weinstein mono-filament test	25%–50% disturbed	65	16
	50%–75% disturbed	62	15
	>75% disturbed	80	19
Vestibular system
Otoscopy	Otitis media/externa	7	2
	Perforated tympanic membrane	13	3
	Deformities tympanic membrane/inner ear caused by trauma or surgery	7	2
Dix-Hallpike maneuver	Positive	44	11
	Unknown^b	31	7
Remaining tests
Corrected visual acuity	Abnormal (ODS ≤0.5 [Snellen metric])	120	29
	Unknown^c	31	7
Additional tests
Cardiovascular system
Electrocardiogram	Atrial fibrillation (known)	13	3
	Atrial fibrillation (new)	5	1
	Bradycardia	7	2
	Premature ventricular complexes in bigeminy	1	0
	Tachycardia (>100/min)	1	0
	Third-degree atrioventricular block	2	0
	Not indicated^d	107	26
Continuous-loop event recording	Bradycardia	1	0
	Sick sinus	1	0
	Tachycardia (>100/min)	2	0
	Premature ending by the patient	3	1
	Premature ending because of allergic response to electrodes	4	1
	Premature ending for other medical reason(s)	3	1
	Not registered^e	357	86
Laboratory tests
Hemoglobin	Moderately severe anemia	5	1
	Severe anemia	3	1
Nonfasting blood glucose	Hyperglycemia	7	2
Psychiatric testing
PRIME-MD Patient Health Questionnaire	One or more of listed diagnoses	174	42
	Major depressive disorder	53	13
	Other depressive disorder	60	14
	Panic disorder	19	5
	Other anxiety disorder	42	10
	Any somatoform disorder	89	21
	Probable alcohol abuse/dependence	10	2
	Any eating disorder	3	1
	Unknown	2	0
Vestibular system
Audiometry	Abnormal audiogram both ears	199	48