9．めまい症状とQOL

抄録

Dizziness is a common symptom with potential impacts on daily life activities that can lead to a decline in the quality of life (QOL). Accurate assessment of persons presenting with dizziness and its effects is crucial for establishing appropriate treatment plans. This review provides an overview of the use of the Dizziness Handicap Inventory (DHI) and Vertigo Symptom Scale-short form (VSS-sf), which are widely used questionnaires for evaluating dizziness and the QOL.

With the advent of new diagnostic tests such as the video Head Impulse Test (vHIT) and vestibular-evoked myogenic potentials, it has become possible to assess semicircular canal and otolith functions in greater detail. However, the subjective dizziness symptom does not always appear to be correlated with objective test results due to factors such as vestibular compensation and psychological state of the patients. In clinical practice, both clinician-reported outcomes (ClinRO) and patient-reported outcomes (PRO) should be considered to ensure a comprehensive assessment of dizziness. DHI and VSS-sf serve as effective PRO tools that facilitate quantification of the symptom severity and treatment efficacy.

DHI, developed by Jacobson and Newman in 1990, assesses the impact of dizziness on daily life activities through three domains: physical, emotional, and functional. It consists of 25 items, with scores ranging from 0 to 100, and higher scores indicate greater disability. The VSS-sf, a shortened version of the Vertigo Symptom Scale (VSS), includes 15 key items and evaluates both vestibular and autonomic symptoms over the previous month, making it a useful tool for efficient screening of the dizziness severity.

Clinical applications of these questionnaires include evaluating the effects of vestibular rehabilitation, identifying psychological factors associated with dizziness, and distinguishing among different vestibular disorders. While DHI is widely used in Japan for QOL assessment of persons presenting with dizziness, the VSS-sf may provide additional insights, particularly with regard to autonomic symptoms. Combined use of these tools could contribute to a more comprehensive understanding of the symptom in persons presenting with dizziness, ultimately improving patient management and enabling selection of the most appropriate treatment strategy.