Abstract of the Week
October Topic: Aging and Vestibular Dysfunction
October 04, 2023
Chepisheva, M. K. (2023). Spatial orientation, postural control and the vestibular system in healthy elderly and Alzheimer’s dementia. PeerJ, 11, e15040
Background: While extensive research has been advancing our understanding of the spatial and postural decline in health elderly (HE) and Alzheimer's disease (AD), much less is known about how the vestibular system contributes to the spatial and postural processing in these two populations. This is especially relevant during turning movements in the dark, such as while walking in our garden or at home at night, where the vestibular signal becomes central. As the prevention of falls and disorientation are of serious concern for the medical service, more vestibular-driven knowledge is necessary to decrease the burden for HE and AD patients with vestibular disabilities.
Methods: Literature review that included open and closed-access articles from PubMed and Google Scholar. Review consisted of articles in the English language only.
Results/Conclusion: Vestibular spatial and vestibular postural deficits present a considerable disadvantage and are felt not only on a physical but also on a psychological level by all those affected. Still, there is a clear need for more (central) vestibular-driven spatial and postural knowledge in healthy and pathological ageing, which can better facilitate our understanding of the etiology of these dysfunctions. A possible change can start with the more frequent implementation of the "vestibular system examination/rehabilitation/therapy" in the clinic, which can then lead to an improvement of future prognostication and disease outcome for the patients.
PMID: 37151287
October 11, 2023
Ozkul, A., & Konukseven, O. (2023). The development of the cognitive vestibular function scale in the elderly complaints of imbalance: a study on validity and reliability. Brazilian Journal of Otorhinolaryngology, 89(4), 101282
Objectives: With a valid and reliable scale, it will make an important contribution to the assessment of cognitive functions such as spatial, spatial-visual, and memory functions, and raise awareness of older people with balance disorders. The purpose of this study is to develop a scale to assess vestibular and cognitive functions in the geriatric population with vestibular disorders and to evaluate its validity and reliability.
Methods: The study involved 75 individuals aged 60 years and older who complained of imbalance. In the first phase, scale items on balance, emotional, spatial, spatial-visual, and memory were created using the literature. The item analysis was completed by a pilot application, and 25 scale items were determined for the main application. The item analysis and validity and reliability analyzes were completed, and the scale was given its final form. For the statistical analysis of the data, a principal component analysis was performed for the validity analysis. The Cronbach alpha coefficient was used for the reliability analysis. Descriptive statistics were compiled on the participants' scale scores.
Results: The Cronbach's alpha value of the scale was found to be highly reliable at 0.86. Statistically significant values were found between the age variable and the spatial subscales, the spatial-visual subscales, and the Cognitive Vestibular Function Scale with a small positive effect (respectively: r = 0.264; p = 0.022; r = 0.237; p = 0.041; r = 0.231; p = 0.046). The results indicate that the Cognitive Vestibular Function Scale is a valid and reliable measurement tool at a good level in elderly people aged 60 years and older.
Conclusion: Cognitive Vestibular Function Scale; was developed to detect cognitive problems related to dizziness/balance. As a result, a preliminary study was conducted to investigate a rapid, easy-to-use, and reliable clinical scale to assess cognitive function in people with balance disorders.
Level II Randomized trials Prospective comparative study.
Keywords: Scale, Spatial, Cognition, Cognitive, Dizziness
PMID: 37418851
October 18, 2023
Fancello V, Hatzopoulos S, Santopietro G, et al. Vertigo in the Elderly: A Systematic Literature Review. J Clin Med. 2023;12(6):2182. Published 2023 March 11. doi:10.3390/jcm12062182
Background: Dizziness and vertigo are among the most prevalent complaints in the elderly and have a major negative influence on (i) the perception of the quality of life; and (ii) the risk of falling. Due to population aging, particularly in wealthy nations, vertigo represents a growing issue and a serious public health concern. In order to approach the patient correctly and to offer the best treatment options, it is mandatory to identify vertigo’s underlying causes. The aim of this paper was to identify the different etiologies of vertigo and possibly their frequency in the elderly population, by reviewing the scientific literature of the last decade (2012–2022).
Methods: A systematic review was performed according to PRISMA guidelines, searching the Medline database from January 2012 through to December 2022. The search identified 1025 candidate papers, but after the application of specific selection criteria, only five were considered for further analysis.
Results: A total of 2148 elderly patients (60–90 y old) presenting with vertigo were reported in the selected papers. A total of 3404 conditions were identified as the cause of vertiginous symptoms, (some patients presented multiple etiologies). All major diagnoses were categorized into different subgroups: the most common origin of vertigo was represented by audio-vestibular disorders (28.4%), followed by cardiovascular (20.4%) and neurological diseases (15.1%). Furthermore, 9.1% of patients were diagnosed with psychiatric conditions, whilst ophthalmologic and musculoskeletal disorders accounted for 7.5% and 6.3% of the cases respectively. Medication adverse effects and metabolic-related diseases were also considered among the causes. For 3.4% of cases the etiology remains unclear.
Conclusions: Audio-vestibular disorders represent the most frequent cause of vertigo in the elderly. The etiologies affecting the vertigo patient must be defined in order to identify potential life-threatening conditions, such as cardiovascular and neurological disorders, which according to the data of this review constitute the second and third common causes of vertigo. A multidisciplinary strategy, involving different specialists (such as ENTs, Neurologists, Cardiologists, Geriatricians) is recommended for the correct assessment of these disorders.
Keywords: vertigo, elderly, etiology, vestibular disorders, BPPV, endolymphatic hydrops, falls
PMID: 36983184
October 25, 2023
Background: Dizziness and vertigo are among the most prevalent complaints in the elderly and have a major negative influence on (i) the perception of the quality of life; and (ii) the risk of falling. Due to population aging, particularly in wealthy nations, vertigo represents a growing issue and a serious public health concern. In order to approach the patient correctly and to offer the best treatment options, it is mandatory to identify vertigo’s underlying causes. The aim of this paper was to identify the different etiologies of vertigo and possibly their frequency in the elderly population, by reviewing the scientific literature of the last decade (2012–2022).
Methods: A systematic review was performed according to PRISMA guidelines, searching the Medline database from January 2012 through to December 2022. The search identified 1025 candidate papers, but after the application of specific selection criteria, only five were considered for further analysis.
Results: A total of 2148 elderly patients (60–90 y old) presenting with vertigo were reported in the selected papers. A total of 3404 conditions were identified as the cause of vertiginous symptoms, (some patients presented multiple etiologies). All major diagnoses were categorized into different subgroups: the most common origin of vertigo was represented by audio-vestibular disorders (28.4%), followed by cardiovascular (20.4%) and neurological diseases (15.1%). Furthermore, 9.1% of patients were diagnosed with psychiatric conditions, whilst ophthalmologic and musculoskeletal disorders accounted for 7.5% and 6.3% of the cases respectively. Medication adverse effects and metabolic-related diseases were also considered among the causes. For 3.4% of cases the etiology remains unclear.
Conclusions: Audio-vestibular disorders represent the most frequent cause of vertigo in the elderly. The etiologies affecting the vertigo patient must be defined in order to identify potential life-threatening conditions, such as cardiovascular and neurological disorders, which according to the data of this review constitute the second and third common causes of vertigo. A multidisciplinary strategy, involving different specialists (such as ENTs, Neurologists, Cardiologists, Geriatricians) is recommended for the correct assessment of these disorders.
Keywords: vertigo, elderly, etiology, vestibular disorders, BPPV, endolymphatic hydrops, falls
PMID: 36983184