Totilienė Milda, Uloza Virgilijus, Lesauskaitė Vita, Damulevičienė Gytė, Kregždytė Rima, Kaski Diego, Ulozienė Ingrida
Department of Otorhinolaryngology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Department of Geriatrics, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Front Aging Neurosci. 2021 Jun 11;13:667608. doi: 10.3389/fnagi.2021.667608. eCollection 2021.
Aging affects the vestibular system and may disturb the perception of verticality and lead to increased visual dependence (VD). Studies have identified that abnormal upright perception influences the risk of falling. The aim of our study was to evaluate subjective visual vertical (SVV) and VD using a mobile virtual reality-based system for SVV assessment (VIRVEST) in older adults with falls and evaluate its relationship with clinical balance assessment tools, dizziness, mental state, and depression level. This study included 37 adults >65 years who experienced falls and 40 non-faller age-matched controls. Three tests were performed using the VIRVEST system: a static SVV, dynamic SVV with clockwise and counter-clockwise background stimulus motion. VD was calculated as the mean of absolute values of the rod tilt from each trial of dynamic SVV minus the mean static SVV rod tilt. Older adults who experienced falls manifested significantly larger biases in static SVV ( = 0.012), dynamic SVV ( < 0.001), and VD ( = 0.014) than controls. The increase in static SVV (odds ratio = 1.365, = 0.023), dynamic SVV (odds ratio = 1.623, < 0.001) and VD (odds ratio = 1.460, = 0.010) tilt by one degree significantly related to falls risk in the faller group. Fallers who had a high risk of falling according to the Tinetti test exhibited significantly higher tilts of dynamic SVV than those who had a low or medium risk ( = 0.037). In the faller group, the increase of the dynamic SVV tilt by one degree was significantly related to falls risk according to the Tinetti test (odds ratio = 1.356, = 0.049). SVV errors, particularly with the dynamic SVV test (i.e., greater VD) were associated with an increased risk of falling in the faller group. The VIRVEST system may be applicable in clinical settings for SVV testing and predicting falls in older adults.
衰老会影响前庭系统，可能会干扰垂直方向的感知并导致视觉依赖（VD）增加。研究表明，异常的直立感知会影响跌倒风险。我们研究的目的是使用基于移动虚拟现实的主观视觉垂直（SVV）评估系统（VIRVEST）来评估老年人跌倒后的主观视觉垂直（SVV）和视觉依赖（VD），并评估其与临床平衡评估工具、头晕、精神状态和抑郁水平之间的关系。本研究纳入了37名65岁以上有跌倒经历的成年人以及40名年龄匹配的无跌倒经历的对照者。使用VIRVEST系统进行了三项测试：静态SVV、伴有顺时针和逆时针背景刺激运动的动态SVV。VD的计算方法是动态SVV每次试验中杆倾斜绝对值的平均值减去静态SVV杆倾斜的平均值。有跌倒经历的老年人在静态SVV（P = 0.012）、动态SVV（P < 0.001）和VD（P = 0.014）方面的偏差明显大于对照组。在跌倒组中，静态SVV（优势比 = 1.365，P = 0.023）、动态SVV（优势比 = 1.623，P < 0.001）和VD（优势比 = 1.460，P = 0.010）倾斜度每增加一度与跌倒风险显著相关。根据Tinetti测试有高跌倒风险的跌倒者动态SVV的倾斜度显著高于低风险或中等风险者（P = 0.037）。在跌倒组中，根据Tinetti测试，动态SVV倾斜度每增加一度与跌倒风险显著相关（优势比 = 1.356，P = 0.049）。SVV误差，尤其是动态SVV测试（即更大的VD）与跌倒组中跌倒风险增加相关。VIRVEST系统可能适用于临床环境中对老年人进行SVV测试和跌倒预测。
