Substantial burden of dizziness in multiple sclerosis

Dizziness affects 49-59% of persons with MS but few prior studies examined the impact of dizziness in persons with multiple sclerosis (MS). Using the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry, we examined the measurement properties of the Dizziness Handicap Inventory (DHI) in persons with MS, and the association between the DHI and health-related quality of life (HRQOL).

In 2004, NARCOMS participants completed the DHI. We scored the DHI for each participant and evaluated the association of the DHI scores and the participant demographic and clinical characteristics of interest using t-tests and Kruskal-Wallis tests as appropriate. We examined the association between the DHI scores and HRQOL (PCS-12, MCS-12) and disability status using Spearman rank correlations and generalized linear models.

8123 participants completed the questionnaire, of whom 74.5% were women and 96.6% were white. Their mean (SD) age of symptom onset was 30.3 (9.7) years and median (IQR) score on Patient Determined Disease Steps (PDDS) was 4 (1-6). The median (interquartile range) DHI score was 20 (0-44). The impact of dizziness could be classified as mild in over 60% of participants (n=4660), moderate in 30.9% (n=2340) and severe in 7.55% (n=572). The odds of reporting moderate or severe dizziness were reduced with higher socioeconomic status (post-graduate degree vs. less than high school education odds ratio [OR] 0.38; 95% confidence interval [CI]: 0.28-0.52) and increased with higher levels of disability (severe vs. mild disability OR 1.38; 95% CI: 1.13-1.68). Physical and mental HRQOL decreased as the impact of dizziness increased (DHI-PCS-12 r=-0.34, DHI-MCS-12 r=-0.37).

Dizziness is common in MS and adversely impacts quality of life. More effective management of this symptom may improve HRQOL and deserves more attention.