Understanding Extremely Elevated Dizziness Handicap Inventory Scores: An Analysis of Predictive Factors

Ann Otol Rhinol Laryngol. 2022 Oct;131(10):1068-1077. doi: 10.1177/00034894211053788. Epub 2021 Oct 25.


Background: The Dizziness Handicap Inventory (DHI) measures impairment in quality of life due to dizziness, with higher scores indicating greater impairment. Little is known about the clinical features that predict extremely elevated DHI scores (eeDHI).

Objective: To identify clinical features associated with eeDHI.

Methods: A retrospective analysis was conducted of 217 patients with dizziness between October 2016 and April 2019. Patients with eeDHI had DHI scores 1 standard deviation higher than the mean. Analyses were performed to generate odds ratios (OR) for having eeDHI based on clinical features and exam findings.

Results: The cut-off for eeDHI scores was 71. In total, 20.7% had eeDHI. Logistic regression identified 6 independent predictors for eeDHI scores: numbness in the face or body during dizziness (OR = 5.99, 95% CI 1.77-20.30), history of falls (OR = 4.37, 95% CI 1.74-10.97), female sex (OR = 2.81, 95% CI 1.18-6.66), caloric weakness (OR = 2.61, 95% CI 1.36-5.01), total number of diagnoses associated with dizziness (OR = 2.17, 95% CI 1.11-4.28), and total number of symptoms during dizziness (OR = 1.25, 95% CI 1.07-1.45).

Conclusions: These findings suggest that patients with eeDHI have severe disease and should be screened for falls. By understanding the drivers of high DHI scores, we can alleviate disease related suffering for vestibular disorders.

Keywords: dizziness; dizziness handicap inventory; falls.

MeSH terms

  • Disability Evaluation
  • Dizziness* / complications
  • Dizziness* / etiology
  • Female
  • Humans
  • Quality of Life
  • Retrospective Studies
  • Vertigo / diagnosis
  • Vestibular Diseases* / complications
  • Vestibular Diseases* / diagnosis