Table 3.

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

Examination by SystemFindingsNo.%
ODS = oculi dexter et sinister; PRIME-MD = Primary Care Evaluation of Mental Disorders.
Note: For diagnostic criteria, see Supplemental Appendix 2, available at
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
    Blood pressureSystolic blood pressure ≥160 mm Hg19848
    Orthostatic hypotension testPositive, without reproduction of symptoms4310
Positive, with reproduction of symptoms5814
    Auscultation of the heartSystolic/diastolic murmur without radiation5714
Systolic/diastolic murmur with radiation4812
Locomotor system
    Orthopedic screeningLimited stability at rest19346
Limited stability during walking17742
Limited mobility hip(s)15237
Limited mobility knee(s)10525
Limited mobility ankle(s)5012
    Tandem gaitTandem gait score ≥40328
Not possible, because of lack of stability11528
    The timed up-and-go testAbnormal (≥20 sec)7117
Not possible, because of lack of stability31
Neurological system
    Tendon reflexesAbnormal patellar tendon reflex8921
Abnormal Achilles tendon reflex6816
Abnormal plantar responses92
    Semmes-Weinstein mono-filament test25%–50% disturbed6516
50%–75% disturbed6215
>75% disturbed8019
Vestibular system
    OtoscopyOtitis media/externa72
Perforated tympanic membrane133
Deformities tympanic membrane/inner ear caused by trauma or surgery72
    Dix-Hallpike maneuverPositive4411
Remaining tests
    Corrected visual acuityAbnormal (ODS ≤0.5 [Snellen metric])12029
Additional tests
Cardiovascular system
    ElectrocardiogramAtrial fibrillation (known)133
Atrial fibrillation (new)51
Premature ventricular complexes in bigeminy10
Tachycardia (>100/min)10
Third-degree atrioventricular block20
Not indicatedd10726
    Continuous-loop event recordingBradycardia10
Sick sinus10
Tachycardia (>100/min)20
Premature ending by the patient31
Premature ending because of allergic response to electrodes41
Premature ending for other medical reason(s)31
Not registerede35786
Laboratory tests
    HemoglobinModerately severe anemia51
Severe anemia31
    Nonfasting blood glucoseHyperglycemia72
Psychiatric testing
    PRIME-MD Patient Health QuestionnaireOne or more of listed diagnoses17442
Major depressive disorder5313
Other depressive disorder6014
Panic disorder195
Other anxiety disorder4210
Any somatoform disorder8921
Probable alcohol abuse/dependence102
Any eating disorder31
Vestibular system
    AudiometryAbnormal audiogram both ears19948