Dizziness and Balance-Related Symptom Burden and 12-Month Fall Risk in U.S. Adults Aged 20 to 69 Years
- 1Fujian Institute of Otorhinolaryngology, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
Abstract
Importance: Falls are often viewed as a problem of older age, yet dizziness and balance-related symptoms are common in adulthood and may help identify adults with elevated fall burden. Objective: To examine associations of dizziness and balance-related symptom burden with 12-month fall outcomes in U.S. adults aged 20 to 69 years and whether objective balance impairment adds information beyond symptoms. Design: Cross-sectional study. Setting: National Health and Nutrition Examination Survey 2021 to 2023. Participants: The primary cohort included 6000 adults aged 20 to 69 years with complete symptom and outcome data. Extension analyses included participants with complete Modified Romberg Test data. Intervention or Exposures: Self-reported dizziness/balance-related symptoms in the past 12 months: vertigo, blurred vision with head movement, unsteadiness, and light-headedness/fainting. Secondary exposures were symptom count and objective balance impairment. Main Outcome Measures: Any fall, recurrent falls (≥3), frequent falls (≥5), and fall-related injury in the past 12 months. Survey-weighted quasi-Poisson regression estimated prevalence ratios (PRs) and 95% confidence intervals (CIs). Results: The weighted prevalence of any dizziness/balance-related symptom was 32.7%. After full adjustment, any symptom was associated with any fall (PR, 1.57; 95% CI, 1.40-1.75), recurrent falls (PR, 3.44; 95% CI, 2.81-4.21), frequent falls (PR, 5.09; 95% CI, 3.64-7.13), and fall-related injury (PR, 2.10; 95% CI, 1.66-2.65). Symptom count showed a dose-response relationship across outcomes. Compared with no symptoms, reporting 3 or more symptoms was associated with PRs of 1.97, 5.24, 8.19, and 3.10, respectively. Objective balance impairment alone showed weaker associations, whereas joint symptom-impairment phenotypes better stratified fall burden. Conclusions: Dizziness and balance-related symptom burden were strongly associated with multiple 12-month fall outcomes in U.S. adults aged 20 to 69 years. Objective balance impairment added limited complementary information beyond symptoms. Relevance: Symptom-based assessment may be a practical first step, with objective balance testing used selectively.
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BibTeX
@article{lin2026dizziness,
title = {{Dizziness and Balance-Related Symptom Burden and 12-Month Fall Risk in U.S. Adults Aged 20 to 69 Years}},
author = {Xing Lin MM and Wen Lv MM and Bo Shu MM and Huimin Cai MM and Heng Xiao MD and Shengnan Ye MD},
journal = {Journal of Otolaryngology - Head and Neck Surgery},
year = {2026},
month = nov,
doi = {10.1177/19160216261494502},
url = {https://doi.org/10.1177/19160216261494502},
note = {CC BY},
}
RIS
TY - JOUR
TI - Dizziness and Balance-Related Symptom Burden and 12-Month Fall Risk in U.S. Adults Aged 20 to 69 Years
AU - Xing Lin MM
AU - Wen Lv MM
AU - Bo Shu MM
AU - Huimin Cai MM
AU - Heng Xiao MD
AU - Shengnan Ye MD
PY - 2026
DA - 2026/11/05
JO - Journal of Otolaryngology - Head and Neck Surgery
DO - 10.1177/19160216261494502
UR - https://doi.org/10.1177/19160216261494502
AB - Importance: Falls are often viewed as a problem of older age, yet dizziness and balance-related symptoms are common in adulthood and may help identify adults with elevated fall burden. Objective: To examine associations of dizziness and balance-related symptom burden with 12-month fall outcomes in U.S. adults aged 20 to 69 years and whether objective balance impairment adds information beyond symptoms. Design: Cross-sectional study. Setting: National Health and Nutrition Examination Survey 2021 to 2023. Participants: The primary cohort included 6000 adults aged 20 to 69 years with complete symptom and outcome data. Extension analyses included participants with complete Modified Romberg Test data. Intervention or Exposures: Self-reported dizziness/balance-related symptoms in the past 12 months: vertigo, blurred vision with head movement, unsteadiness, and light-headedness/fainting. Secondary exposures were symptom count and objective balance impairment. Main Outcome Measures: Any fall, recurrent falls (≥3), frequent falls (≥5), and fall-related injury in the past 12 months. Survey-weighted quasi-Poisson regression estimated prevalence ratios (PRs) and 95% confidence intervals (CIs). Results: The weighted prevalence of any dizziness/balance-related symptom was 32.7%. After full adjustment, any symptom was associated with any fall (PR, 1.57; 95% CI, 1.40-1.75), recurrent falls (PR, 3.44; 95% CI, 2.81-4.21), frequent falls (PR, 5.09; 95% CI, 3.64-7.13), and fall-related injury (PR, 2.10; 95% CI, 1.66-2.65). Symptom count showed a dose-response relationship across outcomes. Compared with no symptoms, reporting 3 or more symptoms was associated with PRs of 1.97, 5.24, 8.19, and 3.10, respectively. Objective balance impairment alone showed weaker associations, whereas joint symptom-impairment phenotypes better stratified fall burden. Conclusions: Dizziness and balance-related symptom burden were strongly associated with multiple 12-month fall outcomes in U.S. adults aged 20 to 69 years. Objective balance impairment added limited complementary information beyond symptoms. Relevance: Symptom-based assessment may be a practical first step, with objective balance testing used selectively.
SN - 1916-0216
ER -