Advanced

Vestibular asymmetry predicts falls among elderly patients with multi- sensory dizziness

Ekvall-Hansson, Eva LU and Magnusson, Måns LU (2013) In BMC Geriatrics 13.
Abstract
Background: Dizziness is the most common symptom in elderly patients and has been identified as a risk factor for falls. While BPPV is the most common cause of dizziness among elderly, multisensory deficits is the second, with visual, vestibular and proprioceptive reduced function. Asymmetric vestibular function is overrepresented in elderly persons with hip fractures and wrist fractures and can be accessed for screening. The objective was to study if vestibular asymmetry, vibration sense, balances performance, postural sway in quiet stance and self-perceived handicap because of dizziness could predict falls among elderly, dizzy patients. Methods: In this prospective study with one year observation period, 55 patients (41 women, 14 men),... (More)
Background: Dizziness is the most common symptom in elderly patients and has been identified as a risk factor for falls. While BPPV is the most common cause of dizziness among elderly, multisensory deficits is the second, with visual, vestibular and proprioceptive reduced function. Asymmetric vestibular function is overrepresented in elderly persons with hip fractures and wrist fractures and can be accessed for screening. The objective was to study if vestibular asymmetry, vibration sense, balances performance, postural sway in quiet stance and self-perceived handicap because of dizziness could predict falls among elderly, dizzy patients. Methods: In this prospective study with one year observation period, 55 patients (41 women, 14 men), 65 to 90 years old (median 80, interquartile range 11) with multisensory dizziness were included. Vestibular function was screened with the headshake test and vibration sense was assessed using a tuning fork. Balance was assessed with four clinical measures and self-perceived dizziness handicap was assessed by the Dizziness Handicap Inventory. Postural sway was measured using a force plate. Results: Headshake test were pathologic in 24 patients, which substantially increased the risk of falls (OR 3.4). Thirteen of the 21 patients who had fallen (p = 0.03), and all 6 patients who sustained three falls or more (p = 0.04), had vestibular asymmetry. No other measure could predict the risk of falls (OR 0.55-1.71). Conclusion: Signs of vestibular asymmetry among elderly with multisensory dizziness could predict falls. Hence, it seems important to address fall-prevention programs to such a group of patients. Simple bedside tests of vestibular asymmetry might be a possibility to screen for one risk factor for falls among elderly. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Dizziness, Vestibular asymmetry, Falls, Prospective
in
BMC Geriatrics
volume
13
publisher
BioMed Central
external identifiers
  • wos:000322272500001
  • scopus:84880335937
ISSN
1471-2318
DOI
10.1186/1471-2318-13-77
language
English
LU publication?
yes
id
85ddf5fe-aa87-4de7-85ec-3ce0ffd2fc41 (old id 4053320)
date added to LUP
2013-10-01 15:18:46
date last changed
2019-01-06 07:36:51
@article{85ddf5fe-aa87-4de7-85ec-3ce0ffd2fc41,
  abstract     = {Background: Dizziness is the most common symptom in elderly patients and has been identified as a risk factor for falls. While BPPV is the most common cause of dizziness among elderly, multisensory deficits is the second, with visual, vestibular and proprioceptive reduced function. Asymmetric vestibular function is overrepresented in elderly persons with hip fractures and wrist fractures and can be accessed for screening. The objective was to study if vestibular asymmetry, vibration sense, balances performance, postural sway in quiet stance and self-perceived handicap because of dizziness could predict falls among elderly, dizzy patients. Methods: In this prospective study with one year observation period, 55 patients (41 women, 14 men), 65 to 90 years old (median 80, interquartile range 11) with multisensory dizziness were included. Vestibular function was screened with the headshake test and vibration sense was assessed using a tuning fork. Balance was assessed with four clinical measures and self-perceived dizziness handicap was assessed by the Dizziness Handicap Inventory. Postural sway was measured using a force plate. Results: Headshake test were pathologic in 24 patients, which substantially increased the risk of falls (OR 3.4). Thirteen of the 21 patients who had fallen (p = 0.03), and all 6 patients who sustained three falls or more (p = 0.04), had vestibular asymmetry. No other measure could predict the risk of falls (OR 0.55-1.71). Conclusion: Signs of vestibular asymmetry among elderly with multisensory dizziness could predict falls. Hence, it seems important to address fall-prevention programs to such a group of patients. Simple bedside tests of vestibular asymmetry might be a possibility to screen for one risk factor for falls among elderly.},
  articleno    = {77},
  author       = {Ekvall-Hansson, Eva and Magnusson, Måns},
  issn         = {1471-2318},
  keyword      = {Dizziness,Vestibular asymmetry,Falls,Prospective},
  language     = {eng},
  publisher    = {BioMed Central},
  series       = {BMC Geriatrics},
  title        = {Vestibular asymmetry predicts falls among elderly patients with multi- sensory dizziness},
  url          = {http://dx.doi.org/10.1186/1471-2318-13-77},
  volume       = {13},
  year         = {2013},
}