Abstract
Aging is associated with progressive declines in both the vestibular and human balance systems. While vestibular lesions certainly contribute to imbalance, the specific contributions of age-related vestibular declines to age-related balance impairment is poorly understood. This gap in knowledge results from the absence of a standardized method for measuring age-related changes to the vestibular balance pathways. The purpose of this manuscript is to provide an overview of the existing body of literature as it pertains to the methods currently used to infer vestibular contributions to age-related imbalance.
Highlights
In the United States, 28–49% of older adults (≥65 years old) fall each year [1, 2]
The video head impulse test and measures of dynamic visual acuity correlate with imbalance in older adults; tests of the low frequency VOR do not
Identifying a method to detect vestibular contributions to age-related postural instability would support efforts to screen for vestibular mediated fall risk and could potentially permit earlier implementation of targeted rehabilitative interventions
Summary
In the United States, 28–49% of older adults (≥65 years old) fall each year [1, 2]. Falls are the most common cause of accidental death in older adults [1], and in non-fatal cases, the costs to manage fall-related sequelae are poised to exceed 55 billion dollars in 2020 [3, 4]. A fall can result from a variety of environmental or physiological causes [7,8,9], a principal contributor to falls among older adults is an age-related decline in balance [8,9,10,11,12]. The ability to maintain equilibrium in a gravitational field by keeping or returning the center of body mass over its base of support” [13] and is the critical component for successful (a) quiet stance, (b) compensatory postural reactions, and (c) anticipatory postural responses It follows, that imbalance (i.e., the lack of balance) be defined as the inability to maintain equilibrium during quiet stance and to anticipate or respond appropriately to postural perturbations. To develop targeted, personalized interventions to combat this epidemic of falls, it is crucial that we develop methods that isolate the primary contributors to an older adult’s imbalance and fall risk
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