Pauwels Sara, Lemkens Nele, Lemmens Winde, Meijer Kenneth, Meyns Pieter, van de Berg Raymond, Spildooren Joke
Faculty of Rehabilitation Sciences, REVAL-Rehabilitation Research Centre, Hasselt University, 3590 Diepenbeek, Belgium.
Department of Otorhinolaryngology and Head and Neck Surgery, School for Mental Health and Neuroscience, Faculty of Health Medicine and Life Sciences, Maastricht University Medical Centre, 6229 Maastricht, The Netherlands.
J Clin Med. 2025 Apr 14;14(8):2666. doi: 10.3390/jcm14082666.
Vestibular hypofunction occurs in 29.5% of older adults with benign paroxysmal positional vertigo (BPPV), but its impact on postural control, well-being and frailty was not studied before. This study compared the well-being, frailty and postural control between older adults with BPPV and vestibular hypofunction (oaBPPV+), and older adults with only BPPV (oaBPPV). Thirty-one older adults (≥65 years old) diagnosed with BPPV were recruited. Unilateral vestibular hypofunction was defined as a >25% caloric asymmetry, and bilateral vestibular hypofunction as a total response <6°/s per ear, using bithermal caloric irrigations. The oaBPPV+ group was compared to the oaBPPV group using the measures of well-being (Dizziness Handicap Inventory, Falls Efficacy Scale and 15-item Geriatric Depression Scale), frailty (Modified Fried Criteria), and postural control (timed chair stand test, mini-Balance Evaluation Systems test and Clinical Test of Sensory Interaction on Balance (CTSIB)). Falls and the number of repositioning maneuvers were documented. Significance level was set at α = 0.05. Unilateral vestibular hypofunction was present in 32% of participants, mainly in females ( = 0.04). Bilateral vestibular hypofunction was not found. The oaBPPV+ group ( = 10, mean age 72.5 (4.5)) experienced more comorbidities ( = 0.02) than the oaBPPV group ( = 21, mean age 72.6 (4.9)). Groups did not differ regarding dizziness symptoms ( = 0.46), fear of falling ( = 0.44), depression ( = 0.48), falls ( = 0.08) or frailty ( = 0.36). However, the oaBPPV+ group showed significantly worse postural control under vestibular-dependent conditions ( < 0.001). Despite equally impaired well-being and frailty, the oaBPPV+ group showed greater sensory orientation deficits. Clinicians and researchers should be alert for co-existing vestibular hypofunction in older adults with BPPV, since this may exacerbate their already impaired postural control more than only BPPV.
29.5%的患有良性阵发性位置性眩晕（BPPV）的老年人存在前庭功能减退，但此前尚未研究其对姿势控制、健康状况和虚弱的影响。本研究比较了患有BPPV和前庭功能减退的老年人（oaBPPV+）与仅患有BPPV的老年人（oaBPPV）之间的健康状况、虚弱程度和姿势控制情况。招募了31名被诊断为BPPV的老年人（≥65岁）。使用冷热交替灌洗法，单侧前庭功能减退定义为冷热试验不对称性>25%，双侧前庭功能减退定义为每侧总反应<6°/秒。使用健康状况指标（头晕残障量表、跌倒效能量表和15项老年抑郁量表）、虚弱程度指标（改良Fried标准）和姿势控制指标（定时起立试验、迷你平衡评估系统测试和平衡感觉交互临床测试（CTSIB））对oaBPPV+组和oaBPPV组进行比较。记录跌倒情况和重新定位动作的次数。显著性水平设定为α = 0.05。32%的参与者存在单侧前庭功能减退，主要为女性（P = 0.04）。未发现双侧前庭功能减退。oaBPPV+组（n = 10，平均年龄72.5（4.5）岁）比oaBPPV组（n = 21，平均年龄72.6（4.9）岁）有更多的合并症（P = 0.02）。两组在头晕症状（P = 0.46）、跌倒恐惧（P = 0.44）、抑郁（P = 0.48）、跌倒（P = 0.08）或虚弱程度（P = 0.36）方面没有差异。然而，在依赖前庭的条件下，oaBPPV+组的姿势控制明显更差（P < 0.001）。尽管健康状况和虚弱程度同样受损，但oaBPPV+组表现出更大的感觉定向缺陷。临床医生和研究人员应警惕患有BPPV的老年人同时存在前庭功能减退的情况，因为这可能比单纯的BPPV更严重地加剧他们本已受损的姿势控制。
