Cognitive Decline and Dementia Trajectories by Dizziness Status in Older Adults.

Dizziness is common in later life and may signal early cognitive vulnerability, but its long-term implications are not well-understood. Data from six waves of the Health and Retirement Study (2000-2020) were used to examine the association of persistent dizziness, defined as dizziness reported in ≥2 waves on cognitive outcomes including longitudinal cognitive score trajectories, dementia risk, and incidence, with age, sex, education, multimorbidity, and polypharmacy controlled. Individuals with persistent dizziness had lower baseline cognitive scores and significantly faster decline over time (β = -0.24, p < .001). Persistent dizziness was associated with a faster rise in dementia risk over time (OR = 1.23, p < .001) and a 36% higher hazard of incident dementia (HR = 1.36, p = 0.004). Persistent dizziness is linked to steeper cognitive decline and elevated dementia risk. These findings support dizziness as a potential early indicator of cognitive vulnerability and highlight its value for screening and preventive care in aging populations.