Abstract
Balance disorders are common issues for aging populations due to the effects of normal aging on peripheral vestibular structures. These changes affect the results of vestibular function evaluations and make the interpretation of these results more difficult. The objective of this article is to review the current state of knowledge of clinically relevant vestibular measures. We will first focus on otolith function assessment methods cervical-VEMP (cVEMP) and ocular-VEMP (oVEMP), then the caloric and video-head impulse test (vHIT) methods for semicircular canals assessment. cVEMP and oVEMP are useful methods, though research on the effects of age for some parameters are still inconclusive. vHIT results are largely independent of age as compared to caloric stimulation and should therefore be preferred for the evaluation of the semicircular canals function.
Highlights
With the accelerating aging of the global population, age-related health issues are becoming a growing concern [1]
Evaluation of Otolith Function The effects of normal aging on vestibular-evoked myogenic potential (VEMP) responses have been analyzed for different parameters, such as peak-to-peak amplitude
CVEMP and Aging One of the most widely observed effects of aging with cVEMP is a decrease in recorded amplitude [15, 19, 29,30,31,32,33,34,35]
Summary
With the accelerating aging of the global population, age-related health issues are becoming a growing concern [1]. Increased risks of falls from loss of balance are among these health concerns [2] and are considered by the WHO as an important burden on both the health care system and health of the population [3]. The vestibular system is located in the inner ear and is composed of three semicircular canals (lateral, anterior, and posterior) that detect angular acceleration and two otolith organs (saccule and utricule) that detect gravity [5]. Information from the saccule and the posterior semicircular canal projects to central vestibular pathways mostly through the inferior vestibular nerve. Information from the utricule, the lateral, and the anterior semicircular canals mostly projects through the superior vestibular nerve [5] and primarily reaches the vestibular nuclei [5]
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