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Evolution of vestibular disorders in older adults: From young-old to middle-old to oldest-old.

Abstract

AIM

This study investigated the evolution of vestibular disorders in dizzy older adults from young-old to middle-old to oldest-old individuals, which has been less examined in detail so far.

METHODS

A total of 3714 older patients with vertigo/dizziness in a university hospital were retrospectively reviewed and divided into three groups; namely, the young-old group aged 65-74 years (n = 2307), the middle-old group aged 75-84 years (n = 1176) and the oldest-old group aged ≥85 years (n = 231). All patients underwent an inner ear test battery comprising audiometry, caloric test, cervical and ocular vestibular-evoked myogenic potential tests, and foam posturography.

RESULTS

The ratios between peripheral and central vestibular disorders ranged from the young-old (60:40%) and middle-old (36:64%) to the oldest-old (25:75%) groups. These results show a decreasing sequence in the prevalence of peripheral vestibular disorders (i.e. benign paroxysmal positional vertigo or Meniere's disease), and an increasing sequence in that of central vestibular disorders (i.e. vertebrobasilar artery insufficiency) from young-old to middle-old to oldest-old patients. Furthermore, the mean Romberg quotients (value from eyes closed divided by that from eyes open) of the sway area on the foam pad were 1.99 ± 0.93, 2.10 ± 1.06 and 2.62 ± 1.78 in the young-old, middle-old and oldest-old groups, respectively, showing a significant difference among them.

CONCLUSIONS

Older patients with central vestibular disorders might be more prone to imbalance and falls than those with peripheral vestibular disorders, partly because patients in the latter group retain other reflex systems; that is, the visuomotor reflex to stabilize the gaze and maintain balance. Hence, adequate vision is important in maintaining balance for older adults with vertigo/dizziness. Geriatr Gerontol Int 2019; ••: ••-••.

Authors+Show Affiliations

Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan.Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31742857

Citation

Jeng, Yu-Jr, and Yi-Ho Young. "Evolution of Vestibular Disorders in Older Adults: From Young-old to Middle-old to Oldest-old." Geriatrics & Gerontology International, 2019.
Jeng YJ, Young YH. Evolution of vestibular disorders in older adults: From young-old to middle-old to oldest-old. Geriatr Gerontol Int. 2019.
Jeng, Y. J., & Young, Y. H. (2019). Evolution of vestibular disorders in older adults: From young-old to middle-old to oldest-old. Geriatrics & Gerontology International, doi:10.1111/ggi.13813.
Jeng YJ, Young YH. Evolution of Vestibular Disorders in Older Adults: From Young-old to Middle-old to Oldest-old. Geriatr Gerontol Int. 2019 Nov 19; PubMed PMID: 31742857.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evolution of vestibular disorders in older adults: From young-old to middle-old to oldest-old. AU - Jeng,Yu-Jr, AU - Young,Yi-Ho, Y1 - 2019/11/19/ PY - 2019/07/25/received PY - 2019/10/17/revised PY - 2019/10/27/accepted PY - 2019/11/20/entrez KW - Romberg quotient KW - falls KW - foam posturography KW - imbalance KW - visuomotor reflex JF - Geriatrics & gerontology international JO - Geriatr Gerontol Int N2 - AIM: This study investigated the evolution of vestibular disorders in dizzy older adults from young-old to middle-old to oldest-old individuals, which has been less examined in detail so far. METHODS: A total of 3714 older patients with vertigo/dizziness in a university hospital were retrospectively reviewed and divided into three groups; namely, the young-old group aged 65-74 years (n = 2307), the middle-old group aged 75-84 years (n = 1176) and the oldest-old group aged ≥85 years (n = 231). All patients underwent an inner ear test battery comprising audiometry, caloric test, cervical and ocular vestibular-evoked myogenic potential tests, and foam posturography. RESULTS: The ratios between peripheral and central vestibular disorders ranged from the young-old (60:40%) and middle-old (36:64%) to the oldest-old (25:75%) groups. These results show a decreasing sequence in the prevalence of peripheral vestibular disorders (i.e. benign paroxysmal positional vertigo or Meniere's disease), and an increasing sequence in that of central vestibular disorders (i.e. vertebrobasilar artery insufficiency) from young-old to middle-old to oldest-old patients. Furthermore, the mean Romberg quotients (value from eyes closed divided by that from eyes open) of the sway area on the foam pad were 1.99 ± 0.93, 2.10 ± 1.06 and 2.62 ± 1.78 in the young-old, middle-old and oldest-old groups, respectively, showing a significant difference among them. CONCLUSIONS: Older patients with central vestibular disorders might be more prone to imbalance and falls than those with peripheral vestibular disorders, partly because patients in the latter group retain other reflex systems; that is, the visuomotor reflex to stabilize the gaze and maintain balance. Hence, adequate vision is important in maintaining balance for older adults with vertigo/dizziness. Geriatr Gerontol Int 2019; ••: ••-••. SN - 1447-0594 UR - https://www.unboundmedicine.com/medline/citation/31742857/Evolution_of_vestibular_disorders_in_older_adults:_From_young-old_to_middle-old_to_oldest-old L2 - https://doi.org/10.1111/ggi.13813 DB - PRIME DP - Unbound Medicine ER -