Bae Seonghoon, Yun Jimin, Kwak Seungmin, Jung Hyuntaek, Lee Hancheol, Kim Juyoung, Kim Chanhee, Lee Yujin, Kim Sunghuhn
Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea.
Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul 03722, Republic of Korea.
Diagnostics (Basel). 2024 Jun 11;14(12):1224. doi: 10.3390/diagnostics14121224.
In 2019, mild vestibular function deficiency in elder populations was defined as presbyvestibulopathy (PVP) by the Classification Committee of the Bárány Society. The diagnostic criteria include tests for low-, mid-, and high-frequency vestibular function, represented by caloric testing, rotary chair testing, and head impulse testing, respectively. However, there is still a lack of large-scale reports supporting the relationship between vestibular function tests (VFTs) and aging. In this study, we evaluated whether each test is correlated with aging in the elderly population aged over 50.
This study retrospectively enrolled 1043 subjects from a single university hospital database after excluding those with unilateral and bilateral vestibulopathy, central dizziness, and acute dizziness. Enrolled subjects had caloric canal paresis <20%, vHIT lateral canal gain >0.6, vHIT interaural difference <0.3, and age >50 years old.
Significant negative correlations with age were identified in the vHIT ( < 0.001) and rotary chair test (RCT) 1.0 Hz gain ( = 0.030). However, the caloric test ( = 0.739 and 0.745 on the left and right sides, respectively) and RCT 0.12 Hz gain ( = 0.298) did not show a significant correlation with age. A total of 4.83% of subjects aged 70 years or older showed sub-normal vHIT gain that met the criteria of PVP, whereas only 0.50% of subjects aged 60 to 69 did. The prevalence of sub-normal caloric test results, however, was not significantly different between the two age groups (21.55% in the 60-69 age group and 26.59% in the >70 age group).
The high-frequency range vestibular function seems vulnerable to aging, and this is more discernible at age >70 years. The weak correlation between age and low-frequency vestibular function tests, such as the caloric test and low-frequency rotary chair testing, suggests the need to revisit the diagnostic criteria for PVP.
2019年，巴兰尼协会分类委员会将老年人群中的轻度前庭功能缺陷定义为老年前庭病（PVP）。诊断标准包括对低频、中频和高频前庭功能的测试，分别以冷热试验、转椅试验和摇头试验为代表。然而，仍缺乏大规模报告支持前庭功能测试（VFTs）与衰老之间的关系。在本研究中，我们评估了每项测试是否与50岁以上老年人群的衰老相关。
本研究从一家大学医院的数据库中回顾性纳入了1043名受试者，排除了患有单侧和双侧前庭病、中枢性头晕和急性头晕的患者。纳入的受试者冷热试验半规管轻瘫<20%，视频头脉冲试验（vHIT）水平半规管增益>0.6，vHIT双耳差值<0.3，且年龄>50岁。
在vHIT（<0.001）和转椅试验（RCT）1.0 Hz增益（=0.030）中发现与年龄存在显著负相关。然而，冷热试验（左侧和右侧分别为=0.739和0.745）和RCT 0.12 Hz增益（=0.298）与年龄未显示出显著相关性。70岁及以上的受试者中，共有4.83%的人vHIT增益低于正常水平，符合PVP标准，而60至69岁的受试者中只有0.50%符合。然而，两个年龄组冷热试验结果低于正常水平的患病率无显著差异（60 - 69岁年龄组为21.55%，>70岁年龄组为26.59%）。
高频范围的前庭功能似乎更容易受到衰老影响，且在70岁以上人群中更为明显。年龄与低频前庭功能测试（如冷热试验和低频转椅试验）之间的弱相关性表明，有必要重新审视PVP的诊断标准。
