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Journal of Medical Research and Clinical Reviews
Research Article
Impact of Earthquakes on Dizziness-Related Disabilities and Quality of Life:
Comparative Analysis
ABSTRACT
Aim: The aim of the study was to examine the effects of the major earthquake that occurred in Turkey in 2023, especially on
symptoms such as dizziness, vertigo and imbalance.
Material and Method: This is a cross-sectional study. The patient group consisted of individuals between the ages of 18-65,
who were exposed to the earthquake, who did not have vestibular, neurological, orthopedic, circulatory or visual problems
that may cause dizziness, and who applied to the hospital with dizziness or vertigo. The control group consisted of partici-
pants with the same age range, who were not exposed to earthquake and did not have health problems (vestibular, neurolog-
ical, orthopedic, circulatory system or visual problems). During the data collection process, written informed consent was
obtained from the participants and demographic information, post-earthquake experiences and life situations were recorded.
Dizziness symptoms and quality of life of the patients were evaluated using the Dizziness Disability Inventory and Verti-
go-Dizziness-Unsteadiness Questionnaire. Normality and homogeneity tests were applied for data analysis, and t test and
ANOVA were used for statistical analysis of the results (p < 0.05).
Result: Statistically significant differences were found between the patient and control groups in “Dizziness”, “Quality of
Life” and “Vertigo Symptoms” (p < 0.05). The scores of the patient group were statistically higher than the control group in
each measurement.
Conclusion: It was concluded that there was a significant relationship between earthquake and “Dizziness”, “Quality of
Life” and “Vertigo Symptoms”.
Keywords: Earthquake, dizziness, imbalance
Introduction
Undoubtedly one of the most remarkable geological phenomena,
earthquakes continue to be discussed in the scientific community
due to their unpredictable nature and their capacity to cause signif-
icant damage to both human life and infrastructure [1].
It is important to recognise that the intense shaking experienced
during earthquakes can have negative effects on both the physical
and emotional well-being of individuals [1-6]. Post-earthquake
health problems may vary depending on the geographical region,
the severity of the earthquake and the effectiveness of the local
health infrastructure. Especially symptoms such as vertigo and
dizziness have a prominent place among the health problems ex-
perienced after the earthquake..
Received Date: 05 March, 2025;
Accepted Date: 10 March, 2025;
Published Date: 14 March, 2025.
Buket Özkara Yılmaz
*Correspondence: Buket Özkara Yılmaz, Gaziantep City Hospital,
Şahinbey/Gaziantep Turkey, Telephone: +905417415185.
Citation: Buket Özkara Yılmaz. Impact of Earthquakes on Dizziness-Related Disabilities and Quality of Life: Compara-
tive Analysis. J Med Res Clin Rev. 2025; 1(1): 1-6.
The expression “dizziness” is a vague term that can include a
range of medical disorders, so it is important to use a step-by-step
approach to distinguish the causes [7]. “Vertigo”, characterized by
a sensation of motion, often perceived as rotational, is a frequent
complaint encountered in primary care settings and emergency de-
partments [8]. Vertigo and dizziness are not distinct disease enti-
ties; instead, they represent nonspecific syndromes encompassing
a diverse range of disorders stemming from various underlying
causes. These symptoms often serve as clinical indicators of un-
derlying medical issues rather than standalone diagnoses. As such,
a comprehensive assessment and diagnostic approach are essential
in order to pinpoint the specific etiology and provide appropriate
management for individuals experiencing vertigo and dizziness [9].
Gaziantep City Hospital, Turkey
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In the literature, significant vertigo and dizziness dysfunctions [7-
10] have been reported in a large area surrounding the epicentre
of the earthquake several months after the first earthquake. These
symptoms may occur as a result of trauma and stress caused by
the earthquake and may negatively affect individuals’ daily life
activities. Therefore, it is vital that post-earthquake health services
are planned to address such symptoms and that the community
develops skills to cope with these problems. Further research on
the health impacts of earthquakes is important to create better pre-
paredness and response strategies for future disasters.
The 7.7 magnitude earthquake recorded in Turkey on 6 February
2023, centred in Kahramanmaraş, caused devastating effects in 11
cities. Following this natural disaster, the effects of the earthquake
were not only limited to physical damages, but also post-earth-
quake health problems were brought to the agenda. In this con-
text, we aim to investigate the effects of symptoms such as dizzi-
ness, vertigo and dizziness on post-earthquake health problems.
This research will contribute to our understanding of the effects
of earthquake on human health and to improve post-earthquake
health services.
Method
Study Design: The design of the study was based on a cross-sec-
tional research design and was carried out taking into account the
inclusion and exclusion criteria. The inclusion criteria for the pa-
tient group were as follows:
1. being between the ages of 18-65,
2. being exposed to the Kahramanmaraş earthquake on 6 Feb-
ruary 2023,
3. Having vertigo or dizziness for at least 2 months,
4. Having no vestibular, neurological, orthopedic, circulatory
system or visual problems that may cause vertigo, dizziness
and balance disorder.
The inclusion criteria for the control group were as follows:
1. being between the ages of 18-65,
2. not having been exposed to the 6 February 2023 earthquake,
3. No neurological, orthopaedic, circulatory system or visual
problems that may cause vertigo, dizziness and balance dis-
orders.
During the conduct of the study, written consent forms were ob-
tained from the patients. These consent forms included the consent
of the participants to voluntarily participate in the study and to
allow the use of their data. In addition, demographic data of the
patients (age, gender, marital status, marital status, educational sta-
tus, chronic disease), their post-earthquake life (house before the
earthquake, a different house, container, tent), and whether they
lived alone or not were also recorded. Dizziness Handicap Inven-
tory and Vertigo-Dizziness-Unsteadiness Questionnaire were ap-
plied to evaluate the level of disability caused by dizziness and
quality of life of the patients after the earthquake.
Dizziness Handicap Inventory (DHI) is an academic scale used to
assess the level of disability and quality of life of patients with diz-
ziness symptoms. This scale consists of a total of 25 questions to
assess the functional, physical and emotional effects of dizziness
in the last 1 month; 9 in the functional, 7 in the physical and 9 in
the emotional domain. The answers to the questions are evaluated
as 0 points for “No”, 2 points for “Sometimes” and 4 points for
“Yes”. In addition to each subcategory score, a total score is also
calculated; the highest total score is 100 and the lowest is 0. Higher
total scores reflect higher levels of disability and lower quality of
life. This scale is used to determine the level of disability, with a
score of 16-34 indicating mild disability, 36-52 indicating moder-
ate disability, and 54 and above indicating severe disability [11].
Vertigo Dizziness Imbalance Questionnaire (VDI) is an academic
scale used to measure the frequency of disability experienced by
patients with vertigo and dizziness symptoms and to understand
how these symptoms affect the quality of daily life of patients. The
scale consists of two main parts: a symptom scale (13 questions)
and a quality of life scale (22 questions). Each question is rated
on a scale of 0 to 5 to assess the frequency of symptoms from
“always” to “never”. Patients are asked to select the answers that
best match the frequency of symptoms. The maximum score for
the symptom scale is 70 and the maximum score for the quality of
life scale is 110. The maximum total score is 180 and a high score
indicates that the patient has few symptoms and good quality of
life in daily life [12].
Data Analysis: In data analysis, appropriate tests (Shapiro-Wilk
normality test and Levene’s homogeneity test) were used to as-
sess the normal distribution and homogeneity of the data. The data
were found to be normal and homogeneous. Independent sample
t-test and ANOVA (analysis of variance) were used for statistical
analyses and p value was accepted as 0.05.
Results
Table 1: Demographic and Socioeconomic Characteristics of Patient and Control Groups
PatientGroup
Control Group
Age
18-29
17(%34,7)
15(%30)
30-39
8(%16,3)
13(%26)
40-49
10(%20,4)
9(%18)
50-59
10(%20,4)
6(%12)
60 andabove
4(%8,2)
7(%14)
Total
49(49,5%)
50(50,5%)
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Gender
Male
24 (%48,0)
26(52,0%)
Female
25(51,0%)
24(48,0%)
Total
49(49,5%)
50(50,5%)
MaritalStatus
Married
31(47,0%)
35(53,0%)
Single
18(54,5%)
15(45,5%)
Total
49(49,5%)
50(50,5%)
Education
Illiterate
4(57,1%)
3(42,9%)
Literate
8(57,1%)
6(42,9%)
Primary School Graduate
4(44,4%)
5(55,6%)
Middle School Graduate
3(33,3%)
6(66,7%)
High School Graduate
17(50,0%)
17(50,0%)
Bachelor’sDegree&
PostgraduateEducation
13(50,0%)
13(50,0%)
Total
49(49,5%)
50(50,5%)
ChronicDiseases
None
36(48,6%)
38(51,4%)
Hypertension
8(53,3%)
7(46,7%)
Diabetes
3(42,9%)
4(57,1%)
Depression
1(100,0%)
0(0,0%)
LungDisease
1(50,0%)
1(50,0%)
Total
49(49,5%)
50(50,5%)
CurrentResidence
InthePrevious Home
beforetheEarthquake
27(35,1%)
50(64,9%)
MovedtoAnother Home
9(100,0%)
0(0,0%)
WithRelatives/Friends
4(100,0%)
0(0,0%)
In a Container
5(100,0%)
0(0,0%)
In a Tent
4(100,0%)
0(0,0%)
Do you live alone
Yes
7(63,6%)
4(36,4%)
No
42(47,7%)
46(52,3%)
Total
49(49,5%)
50(50,5%)
Table 1 provides a comprehensive dataset that compares various
demographic and health characteristics between the patient and
control groups. Regarding age distribution, it’s evident that the
number of individuals in the 18-29 age range is roughly equiv-
alent in both patient and control groups. Nevertheless, as age in-
creases, the patient group becomes more predominant, particularly
in individuals aged 60 and above. Gender distribution exhibits a
balanced representation in both groups, with nearly identical gen-
der ratios. In terms of marital status, the patient group comprises
fewer married individuals compared to the control group, possibly
suggesting a correlation between health issues and marital status.
The educational level shows no significant disparities between
the two groups, with individuals from diverse educational back-
grounds present in both. The prevalence of chronic diseases like
hypertension and diabetes is notably higher in the patient group,
implying a greater burden of health issues among this cohort. The
present housing situation indicates alterations following the earth-
quake, as most individuals in the control group continue to live in
their homes from before the earthquake. Conversely, some indi-
viduals in the patient group have moved to different locations. To
conclude, an examination of living conditions discloses a slightly
elevated percentage of individuals living independently within the
patient group compared to the control group.
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Table 2: Mean Scores for Dizziness, Quality of Life, and Vertigo Symptoms by Demographic and Socioeconomic Characteristics

Dizziness
Quality of Life
VertigoSymptom
Mean
p
Mean
p
Mean
p
Age
18-29
44,35
0,541
62,94
0,421
33,18
0,511
30-39
50,50
52,75
28,75
40-49
54,00
48,20
24,20
50-59
56,00
45,50
25,60
60 andabove
50,50
56,50
33,50
Gender
Female
51,28
0,678
52,56
0,65
26
0,131
Male
49,08
55,88
32,33
MaritalStatus
Married
52,32
0,291
50,84
0,22
27,55
0,29
Single
46,56
59,94
31,78
Education
Illiterate
47,5
0,142
53,5
0,08
28
0,16
Literate
55,5
47,13
28,25
Primary School Graduate
68,5
28,75
13,25
Middle School Graduate
35,33
76,67
37,67
High School Graduate
45,29
62,53
33,76
Bachelor’sDegree&
PostgraduateEducation
52
50,46
26,77
ChronicDiseases
None
47,94
0,159
57,22
0,4
30,17
0,409
Hypertension
56,5
45,5
24,75
Diabetes
43,33
59
36,67
Depression
86
22
7
LungDisease
66
32
25
CurrentResidence
InthePrevious Home
beforetheEarthquake
50
0,498
54,44
0,66
29,22
0,749
MovedtoAnother Home
47,11
55,11
30,44
WithRelatives/Friends
64,5
40,75
20,5
In a Container
51,6
50,8
28,6
In a Tent
42,5
68
34,5
Do you live alone

Yes
52,29
0,748
46,29
0,37
25,86
0,386
No
49,86
55,5
29,64
We aimed to evaluate how demographic variables affect the disease
in the patient group. Anova test was applied, but no statistically
significant result was obtained. The results show that demographic
variables do not have a significant effect on the disease (Table 2).
Statistically significant disparities in dizziness severity were iden-
tified between the patient and control groups (p < 0.05). In the
patient group, the average severity of dizziness measured at 50.2
(52.00), whereas in the control group, it was quantified at 29.44
(28.00). Dizziness was notably more prevalent in the patient group
(Table 3).
Table 3: Comparison of Handicap Severity between Patient and Control Groups

PatientGroup
Control Group
p
N/%
Mean (Median)
N/%
Mean (Median)
MildHandicap
12(24,5)
50,2(52,00)
34 (68,0)
29,44 (28,00)
0,00
ModerateHandicap
14(28,6)
15 (30,0)
Severe Handicap
23(46,9)
1 (2,0)
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“Quality of Life” and “Vertigo Symptom” levels were compared
between the patient group and the control group. The quality of
life level of the patient group was 54.18 (41.00 median value),
while the quality of life of the control group showed a statistical-
ly significant difference. Similarly, the dizziness symptom of the
patient group was 29.1 (26.00 median value), while the dizziness
symptom of the control group was 48.04 (50.00). In conclusion,
quality of life was lower and dizziness symptom was more com-
mon in the patient group (Table 4).
Table 4: Comparison of Quality of Life and Vertigo Symptoms between Patient and Control Groups
PatientGroup
Control Group
p
Min-Max
Mean (Median)
Min-Max
Mean (Median)
Quality of Life
16-103
54,18 (41,00)
32-103
83,1 (87,50)
0,00
VertigoSymptom
5-56
29,1 (26,00)
20-60
48,04 (50,00)
0,00
Discussion
Earthquakes have historically been a major threat to humanity and
have caused many disasters. However, the effects of earthquakes
on human health are still not fully understood. Therefore, in this
article, we focused on examining the potential effects of earth-
quake on human health (dizziness, Vertigo Dizziness). The find-
ings of our study are quite remarkable.
In our study, it was observed that dizziness was more common in
the patient group. In addition, statistically significant differences
were found in Quality of Life and Vertigo Symptom levels. These
results suggest that earthquake may be associated with dizziness
and vertigo symptoms. In a study conducted by Miwa et al. [9],
it was reported that there was a relationship between earthquake
and dizziness. In addition, Tevzadze et al. [13] reported that
earthquake may increase secondary benign paroxysmal position-
al vertigo (BPPV) symptoms and that these symptoms are often
associated with anxiety. Similarly, Hasegawa et al. [14] reported
that cases of vertigo, Meniere’s disease and acute low-tone sen-
sorineural hearing loss increased following similar disasters, and
4.8% of patients suffering from these neuro-otological disorders
had complications of depression and other mental disorders. Fur-
thermore, Tevzadze and Shakarishvili [15] suggested that earth-
quake may cause symptoms such as panic attacks, anxiety and
psychogenic vertigo and trigger the transition from organic verti-
go to BPPV. These results suggest that physical stress factors such
as imbalance caused by earthquake, sensory disturbances caused
by earthquake vibrations, changes in living conditions and auto-
nomic stress may be effective on dizziness [9].
In our study, the effects of demographic variables on dizziness,
Quality of Life and Vertigo Symptom were analysed. Analyses
performed on the patient group showed that demographic vari-
ables did not have a statistically significant effect on dizziness,
Quality of Life and Vertigo Symptom. Although our study showed
that post-earthquake dizziness syndrome was not related to demo-
graphic factors, there are results in the opposite direction in the lit-
erature. In the study of Miwa et al. [9], it was reported that demo-
graphic factors such as 21 ≥, female and building floor number 3
≥ were associated with visual and somatosensory symptoms such
as anxiety and autonomic symptoms (such as sweating abnormal-
ities and digestive difficulties). Nomura and Toi [16] investigated
post-earthquake dizziness syndrome. According to the results of
the study, dizziness complaints were higher in women than in men
and dizziness complaints were more common among adults under
the age of 50. In the same study, it was reported that among school
children, dizziness syndrome was more common among primary
school students than among middle and high school students.
Limitation of Our Study
This study utilised a cross-sectional design and is based on data
obtained only during a specific time period and is therefore limited
for assessing long-term changes or causal relationships. The sam-
ple used in the study focussed on a specific age range and a specific
geographical region. Therefore, the generalisability of the results
obtained is limited and cannot be generalised to individuals with
other demographic characteristics.
Conculusion
According to the results of the study, Dizziness Handicap Inven-
tory (DHI) and Vertigo Dizziness Imbalance Questionnaire (VDI)
scores were significantly higher in the post-earthquake patient
group. The findings of our study indicate that post-earthquake
dizziness and balance problems may have negative effects on pa-
tients’ quality of life. These results provide important clues for
health management and policy makers who evaluate the health
problems that may occur after the earthquake.
Financial Support
This study was carried out without any financial support.
Funding statement
None
Conflict Of Interest
There is no conflict of interest of this study.
Informed consent/ Patient consent
Informed consent was obtained from patients
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