Prevalence and factors associated with Benign paroxysmal positional vertigo and fall in Hajj: A Cross-Sectional Study
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Abstract
Background and aim: Benign paroxysmal positional vertigo (BPPV) is a common vestibular disorder, typically affecting older adults, and is a recognized cause of vertigo and falls. The physically demanding conditions of Hajj may increase dizziness and fall risk, yet BPPV has not been studied in this mass-gathering context. This study aimed to estimate the self-reported prevalence of BPPV and falls among Hajj pilgrims, and to explore self-reported triggers of dizziness.
Methods: A cross-sectional survey was conducted during Hajj 2022–2023 using a validated Arabic questionnaire adapted from published BPPV screeners. Diagnosis of probable BPPV was based solely on self-reported responses to two screening items (brief vertigo episodes <1 minute provoked by specific positional changes). The questionnaire also assessed demographics, comorbidities, falls, and self-reported triggers of dizziness during religious activities.
Results: Of 183 respondents, 144 were eligible for analysis (mean age = 36.8 years; range = 16–72). Overall, 22.2% (95% CI: 15.7%–29.9%), reported dizziness, but only 1.4% (95% CI: 0.2%–4.9%) met the self-reported criteria for probable BPPV. The incidence of falls during Hajj was 2.1% (95% CI: 0.4%–6.0%), with no significant association with BPPV. Bowing during prayer was the only religious activity significantly associated with BPPV, although this was based on just two BPPV-positive cases.
Conclusion: The prevalence of BPPV was low in this predominantly young sample, limiting generalizability to the wider pilgrim population, which usually includes many older adults. Findings highlight the need for age-diverse, clinically confirmed studies to better understand vestibular health risks during Hajj.
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