Abstract
Objective: To assess the perception of disability in patients with presbyvestibulopathy and to determine the factors (demographic, balance test scores, and comorbidities) that determine higher levels of disability.Material and Methods: This was a cross-sectional study conducted in a tertiary university hospital. There were 103 patients who fulfilled the diagnostic criteria for presbyvestibulopathy and were included. Dizziness Handicap Inventory (DHI) score was the main variable used to quantify disability. Influence on DHI score, sex, age, time of evolution, equilibriometric parameters (posturographic scores and timed up and go test), history of falls, comorbidities (high blood pressure, diabetes, and dyslipidemia), psychotropic drug use, tobacco or alcohol use, living environment (urban or rural), and active lifestyle were analyzed.Results: Most of the DHI scores showed a moderate (46 patients, 44.7%) or severe (39 participants, 37.9%) handicap. DHI scores were higher in women (59.8 vs. 36.1, p < 0.001), patients with obesity (58.92 vs. 48.68; p = 0.019), benzodiazepine (59.9 vs. 49.1, p = 0.008) or other psychotropic drug (60.7 vs. 49.2, p = 0.017) users, and fallers (57.1 vs. 47.3, p = 0.048). There was also a significant positive correlation between DHI score, time (Rho coefficient: 0.371, p < 0.001), and steps (Rho coefficient: 0.284, p = 0.004) used in the TUG and with the short FES-I questionnaire (a shortened version of the Falls Efficacy Scale-International) score (Rho coefficient: 0.695, p < 0.001). DHI scores were lower in alcohol consumers than in non-drinkers (46.6 vs. 56, p = 0.048). No significant correlation was found between DHI scores and age, time of evolution, posturographic scores, comorbidities, environment (rural or urban), or active lifestyle.Conclusion: Most patients with presbyvestibulopathy show an important subjective perception of disability in relation to their symptoms. This perception is substantially higher in women than in men. The most influential factors are difficulties in walking, fear of falling, and obesity.Unique Identifier: NCT03034655, www.clinicaltrials.gov.
Highlights
Vestibular symptoms in the elderly are common and may result in reduced quality of life of these individuals [1]
Various medications frequently used in older people may slow vestibular reflexes
This clinical trial, the full protocol for which has already been published [14], aims to determine whether vestibular rehabilitation is useful in elderly patients with instability for improving their balance and reducing their risk of falling
Summary
Vestibular symptoms in the elderly are common and may result in reduced quality of life of these individuals [1] Their consequences (primarily limiting mobility and increasing the risk of falls) are especially serious in this age group, leading to social isolation, and to direct morbidity and mortality (derived from eventual fractures caused by falls) [2]. Health care for these patients is a major challenge for public healthcare systems [3]. Aging itself may cause histologically demonstrable damage to vestibular receptors and organs [7,8,9] which may be responsible for the symptoms of dizziness, imbalance, or instability frequently reported by elderly people
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