Abstract
BackgroundDizziness 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.MethodsIn 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.ResultsHeadshake 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).ConclusionSigns 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.
Highlights
Dizziness is the most common symptom in elderly patients and has been identified as a risk factor for falls
Asymmetric vestibular function is overrepresented in elderly persons with hip fractures [8] and wrist fractures
A total of 62 patients were assessed for eligibility in the study and 55 patients were included, 41 women and 14 men, 65 to 90 years old
Summary
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 prevalence of dizziness among elderly is substantial [2] and has been identified as a risk factor for falls [3]. Asymmetric vestibular function is overrepresented in elderly persons with hip fractures [8] and wrist fractures [9] and vestibular disorders may be unrecognized as a cause to dizziness in the elderly [10]
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