Pauwels Sara, Lemkens Nele, Lemmens Winde, Meijer Kenneth, Meyns Pieter, Berg Raymond V D, Spildooren Joke
Faculty of Rehabilitation Sciences, REVAL-Rehabilitation Research Centre, Hasselt University, Hasselt Diepenbeek, Limburg, Belgium (S.P., P.M., J.S.); Department of Otorhinolaryngology and Head & Neck Surgery, School for Mental Health and Neuroscience, Faculty of Health Medicine and Life Sciences, Maastricht University Medical Centre, The Netherlands (S.P., R.V.D.B); Department of Otorhinolaryngology, Head and Neck Surgery ZOL Hospital, Belgium (N.L., W.L.); and Department of Nutrition and Movement Sciences, NUTRIM Institute of Nutrition and Translational Research in Metabolism, Maastricht University, The Netherlands (K.M.).
J Neurol Phys Ther. 2025 Apr 1;49(2):99-107. doi: 10.1097/NPT.0000000000000495. Epub 2024 Nov 22.
Even though Benign Paroxysmal Positioning Vertigo (BPPV) is one of the most reported vestibular disorders, its interaction with frailty and postural control in older adults is hardly or not investigated.
Thirty-seven older adults (≥65 years) with a diagnosis of BPPV (oaBPPV) (mean age 73.13 (4.8)) were compared to 22 age-, weight-, and height-matched controls (mean age 73.5 (4.5)). Modified Fried criteria were used to assess frailty. Postural control was assessed with the timed chair stand test, mini Balance Systems Evaluation test (mini-BESTest), a Clinical Test of Sensory Interaction on Balance (CTSIB), and 10-m walk test. Falls were inquired. The Dizziness Handicap Inventory, Falls Efficacy Scale, and 15-item Geriatric Depression Scale assessed dizziness-related handicap, fear of falling, and feelings of depression, respectively. To assess the importance of frailty, all variables were also compared between frail oaBPPV, robust oaBPPV, and robust controls in a sub-analysis. The significance level was set at α = 0.05.
oaBPPV reported significantly more multiple falls ( P = 0.05) and difficulties to remain standing with increasing task difficulty of the CTSIB ( P = 0.004). They were significantly more (pre-)frail compared to controls ( P < 0.001). Moreover, frail oaBPPV had a significantly decreased reactive postural control ( P < 0.001) and dynamic gait ( P < 0.001). Their fear of falling ( P < 0.001) and dizziness-related handicap ( P < 0.001) were significantly higher compared to robust oaBPPV.
oaBPPV were less healthy and more (pre-)frail compared to controls, impacting their daily functioning. Future research should investigate whether frailty and postural control were already decreased before the BPPV onset and if this recovers after treatment with repositioning maneuvers or if additional rehabilitation is necessary.
Older adults with Benign Paroxysmal Positional Vertigo (BPPV) can present with an impaired sensory orientation, declined cognition, significantly more multiple falls, and (pre-)frailty compared to controls. Moreover, frail older adults with BPPV also had a significantly decreased reactive postural control and dynamic gait, and an increased odds of falling compared to robust controls. BPPV and frailty appear to be linked with each other, which cannot be ignored in future research and clinicians treating older adults with BPPV.
尽管良性阵发性位置性眩晕（BPPV）是报告最多的前庭疾病之一，但在老年人中其与衰弱及姿势控制之间的相互作用却很少或未得到研究。
将37名诊断为BPPV（老年BPPV，oaBPPV）的老年人（≥65岁）（平均年龄73.13（4.8）岁）与22名年龄、体重和身高匹配的对照组（平均年龄73.5（4.5）岁）进行比较。采用改良的弗里德标准评估衰弱状况。通过定时起立试验、简易平衡系统评估测试（mini-BESTest）、平衡感觉交互作用临床测试（CTSIB）和10米步行试验评估姿势控制。询问跌倒情况。眩晕 handicap 量表、跌倒效能感量表和15项老年抑郁量表分别评估与眩晕相关的障碍、跌倒恐惧和抑郁情绪。为评估衰弱的重要性，在一项亚分析中还比较了衰弱的老年BPPV组、强健的老年BPPV组和强健的对照组之间的所有变量。显著性水平设定为α = 0.05。
老年BPPV组报告的多次跌倒显著更多（P = 0.05），并且随着CTSIB任务难度增加，保持站立有困难（P = 0.004）。与对照组相比，他们明显更（处于前期）衰弱（P < 0.001）。此外，衰弱的老年BPPV组的反应性姿势控制（P < 0.001）和动态步态（P < 0.001）显著下降。与强健的老年BPPV组相比，他们的跌倒恐惧（P < 0.001）和与眩晕相关的障碍（P < 0.001）显著更高。
与对照组相比，老年BPPV组健康状况较差且更（处于前期）衰弱，影响他们的日常功能。未来研究应调查在BPPV发作之前衰弱和姿势控制是否已经下降，以及在进行复位手法治疗后是否恢复，或者是否需要额外的康复治疗。
与对照组相比，患有良性阵发性位置性眩晕（BPPV）的老年人可能存在感觉定向受损、认知能力下降、多次跌倒显著更多以及（处于前期）衰弱的情况。此外，与强健的对照组相比，衰弱的老年BPPV患者的反应性姿势控制和动态步态也显著下降，跌倒几率增加。BPPV与衰弱似乎相互关联，这在未来研究以及治疗老年BPPV患者的临床医生中不可忽视。
