The Dizziness Handicap Inventory (DHI) is a 25-question form used to estimate how dizziness affects daily activity, emotions, confidence, travel, work, and movement. It does not diagnose the cause of dizziness by itself, but it helps track how much the problem is affecting real life.
Dizziness Handicap Inventory: quick answer
DHI gives a score from 0 to 100. A higher score usually means dizziness is causing more physical limitation, emotional distress, and daily-life restriction. The score should be interpreted with history, examination, vestibular testing, hearing clues, blood pressure, medicine review, migraine screening, and red flags.
What the DHI score means
The commonly used interpretation is: lower scores suggest mild handicap, middle-range scores suggest moderate handicap, and higher scores suggest severe impact. These categories are useful for follow-up, but they are not a diagnosis and should not be used to decide treatment without clinical review.
- Physical: movement, looking up, bending, walking, and activity-related dizziness.
- Emotional: frustration, fear, anxiety, embarrassment, and confidence loss.
- Functional: work, travel, social activity, household tasks, and independence.
Why DHI does not diagnose the cause
A high DHI score can happen with BPPV, vestibular migraine, Meniere’s disease, PPPD, bilateral vestibular loss, medication side effects, orthostatic dizziness, anxiety-related dizziness, visual vertigo, or neurological disease. The same score can come from very different causes.
How it helps treatment follow-up
Repeating DHI during vestibular rehabilitation or chronic dizziness treatment can show whether function is improving. A useful improvement is not only a lower number; it should match better walking confidence, fewer avoided situations, safer activity, improved sleep, reduced rescue medicine, or return to work and travel.
Red flags
A DHI form should never hide urgent symptoms. Fainting, chest pain, one-sided weakness, slurred speech, double vision, new severe headache, sudden hearing loss, repeated falls, or inability to walk needs medical assessment rather than only score tracking.
Related guides
- Chronic vertigo guide
- PPPD treatment guide
- Vestibular rehabilitation therapy
- Vertigo diagnosis guide
- Vertigo red flag check
References
- Jacobson GP, Newman CW. The development of the Dizziness Handicap Inventory. Arch Otolaryngol Head Neck Surg. 1990;116(4):424-427.
- Staab JP, Eckhardt-Henn A, Horii A, et al. Diagnostic criteria for persistent postural-perceptual dizziness. J Vestib Res. 2017.
- McDonnell MN, Hillier SL. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database Syst Rev. 2015.
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Medical disclaimer: This page is for education only. Dizziness can be vestibular, neurological, cardiac, medication-related, functional, or anxiety-linked. Diagnosis should be individualized after clinical evaluation.