Presbyvestibulopathy, Comorbidities, and Perception of Disability: A Cross-Sectional Study

Andrés Soto-Varela, Marcos Rossi-Izquierdo, María Del-Río-Valeiras, Isabel Vaamonde-Sánchez-Andrade, Ana Faraldo-García, Antonio Lirola-Delgado, Sofía Santos-Pérez, Andrés Soto-Varela, Marcos Rossi-Izquierdo, María Del-Río-Valeiras, Isabel Vaamonde-Sánchez-Andrade, Ana Faraldo-García, Antonio Lirola-Delgado, Sofía Santos-Pérez

Abstract

Objective: To assess the perception of disability in patients with presbyvestibulopathy and to determine the factors (demographic, balance test scores, and comorbidities) that determine higher levels of disability. Material and Methods: This was a cross-sectional study conducted in a tertiary university hospital. There were 103 patients who fulfilled the diagnostic criteria for presbyvestibulopathy and were included. Dizziness Handicap Inventory (DHI) score was the main variable used to quantify disability. Influence on DHI score, sex, age, time of evolution, equilibriometric parameters (posturographic scores and timed up and go test), history of falls, comorbidities (high blood pressure, diabetes, and dyslipidemia), psychotropic drug use, tobacco or alcohol use, living environment (urban or rural), and active lifestyle were analyzed. Results: Most of the DHI scores showed a moderate (46 patients, 44.7%) or severe (39 participants, 37.9%) handicap. DHI scores were higher in women (59.8 vs. 36.1, p < 0.001), patients with obesity (58.92 vs. 48.68; p = 0.019), benzodiazepine (59.9 vs. 49.1, p = 0.008) or other psychotropic drug (60.7 vs. 49.2, p = 0.017) users, and fallers (57.1 vs. 47.3, p = 0.048). There was also a significant positive correlation between DHI score, time (Rho coefficient: 0.371, p < 0.001), and steps (Rho coefficient: 0.284, p = 0.004) used in the TUG and with the short FES-I questionnaire (a shortened version of the Falls Efficacy Scale-International) score (Rho coefficient: 0.695, p < 0.001). DHI scores were lower in alcohol consumers than in non-drinkers (46.6 vs. 56, p = 0.048). No significant correlation was found between DHI scores and age, time of evolution, posturographic scores, comorbidities, environment (rural or urban), or active lifestyle. Conclusion: Most patients with presbyvestibulopathy show an important subjective perception of disability in relation to their symptoms. This perception is substantially higher in women than in men. The most influential factors are difficulties in walking, fear of falling, and obesity. Unique Identifier: NCT03034655, www.clinicaltrials.gov.

Keywords: DHI; comorbidities; disability; dizziness handicap inventory; handicap; presbyvestibulopathy.

Copyright © 2020 Soto-Varela, Rossi-Izquierdo, del-Río-Valeiras, Vaamonde-Sánchez-Andrade, Faraldo-García, Lirola-Delgado and Santos-Pérez.

References

    1. Agrawal Y, Pineault KG, Semenov YR. Health-related quality of life and economic burden of vestibular loss in older adults. Laryngoscope Investig Otolaryngol. (2018) 3:8–15. 10.1002/lio2.129
    1. Zalewski CK. Aging of the human vestibular system. Semin Hear. (2015) 36:175–96. 10.1055/s-0035-1555120
    1. Ungar A, Rafanelli M, Iacomelli I, Brunetti MA, Ceccofiglio A, Tesi F, et al. . Fall prevention in the elderly. Clin Cases Miner Bone Metab. (2013) 10:91–5.
    1. Public Health England with the National Falls Prevention Coordination Group member organisations Falls and Fracture Consensus Statement. Supporting Commissioning for Prevention. (2017). Available online at: (accessed 1 July, 2020).
    1. Updated American Geriatrics Society/British Geriatrics Society Clinical Practice Guideline for Prevention of Falls in Older Persons and Recommendations: Prevention of Falls in Older Persons AGS BGS Clinical Practice Guideline 2010 (2010) Available online at: (accessed 01 July, 2020)
    1. Shoair OA, Nyandege AN, Slattum PW. Medication-related dizziness in the older adult. Otolaryngol Clin North Am. (2011) 44:455–71. 10.1016/j.otc.2011.01.014
    1. Rosenhall U, Rubin W. Degenerative changes in the human vestibular sensory epithelia. Acta Otolaryngol. (1975) 79:67–80. 10.3109/00016487509124657
    1. Kristinsdottir EK, Nordell E, Jarnlo GB, Tjäder A, Thorngren KG, Magnusson M. Observation of vestibular asymmetry in a majority of patients over 50 years with fall-related wrist fractures. Acta Otolaryngol. (2001) 121:481–85. 10.1080/000164801300366624
    1. Walther LE, Westhofen M. Presbyvertigo-aging of otoconia and vestibular sensory cells. J Vestib Res. (2007) 17:89–92.
    1. Agrawal Y, Van De Berg R, Wuyts F, Walther L, Magnusson M, Oh E, et al. . Presbyvestibulopathy: diagnostic criteria Consensus document of the classification committee of the Bárány Society. J Vestib Res. (2019) 29:161–70. 10.3233/VES-190672
    1. Jacobson GP, Newman CW. The development of the dizziness handicap inventory. Arch Otolaryngol Neck Surg. (1990) 116:424–7. 10.1001/archotol.1990.01870040046011
    1. Pérez N, Garmendia I, Martín E, García-Tapia R. [Cultural adaptation of 2 questionnaires for health measurement in patients with vertigo]. Acta Otorrinolaringol Esp. (2000) 51:572–80.
    1. Whitney SL, Wrisley DM, Brown KE, Furman JM. Is perception of handicap related to functional performance in persons with vestibular dysfunction? Otol Neurotol. (2004) 25:139–43. 10.1097/00129492-200403000-00010
    1. Soto-Varela A, Gayoso-Diz P, Faraldo-García A, Rossi-Izquierdo M, Vaamonde-Sánchez-Andrade I, Del-Río-Valeiras M, et al. . Optimising costs in reducing rate of falls in older people with the improvement of balance by means of vestibular rehabilitation (ReFOVeRe study): a randomized controlled trial comparing computerised dynamic posturography vs mobile vibrotactile posturography system. BMC Geriatr. (2019) 19:1. 10.1186/s12877-018-1019-5
    1. Vaillant J, Martigné P, Vuillerme N, Caillat-Miousse J-L, Parisot J, Juvin R, et al. . [Prediction of falls with performance on timed “Up-and-Go” and one-leg-balance tests and additional cognitive tasks]. Ann Réadaptation Médecine Phys. (2006) 49:1–7. 10.1016/j.annrmp.2005.07.002
    1. Rossi-Izquierdo M, Gayoso-Diz P, Santos-Pérez S, Del-Río-Valeiras M, Faraldo-García A, Vaamonde-Sánchez-Andrade I, et al. . Short-term effectiveness of vestibular rehabilitation in elderly patients with postural instability: a randomized clinical trial. Eur Arch Otorhinolaryngol. (2017) 274:2395–403. 10.1007/s00405-017-4472-4
    1. Kempen GI, Yardley L, van Haastregt JC, Zijlstra GA, Beyer N, Hauer K, et al. . The Short FES-I: a shortened version of the falls efficacy scale-international to assess fear of falling. Age Ageing. (2008) 37:45–50. 10.1093/ageing/afm157
    1. Weinstein BE. Screening for otologic functional impairments in the elderly: whose job is it anyway? Audiol Res. (2011) 1:e12. 10.4081/audiores.2011.e12
    1. Clarke EL, Evans JR, Smeeth L. Community screening for visual impairment in older people. Cochrane Database Syst Rev. (2018) 2:CD001054. 10.1002/14651858.CD001054.pub3
    1. Lee KY. Pathophysiology of age-related hearing loss (Peripheral and central). Korean J Audiol. (2013) 17:45–9. 10.7874/kja.2013.17.2.45
    1. Lasisi AO, Gureje O. Disability and quality of life among community elderly with dizziness: Report from the Ibadan Study of Ageing. J Laryngol Otol. (2010) 124:957–62. 10.1017/S0022215110000538
    1. Ciorba A, Bianchini C, Scanelli G, Pala M, Zurlo A, Aimoni C. The impact of dizziness on quality-of-life in the elderly. Eur Arch Otorhinolaryngol. (2017) 274:1245–50. 10.1007/s00405-016-4222-z
    1. Rossi-Izquierdo M, Santos-Pérez S, Del-Río-Valeiras M, Lirola-Delgado A, Faraldo-García A, Vaamonde-Sánchez-Andrade I, et al. . Is there a relationship between objective and subjective assessment of balance in elderly patients with instability? Eur Arch Otorhinolaryngol. (2015) 272:2201–6. 10.1007/s00405-014-3122-3
    1. Robertson DD, Ireland DJ. Dizziness Handicap Inventory correlates of computerized dynamic posturography. J Otolaryngol. (1995) 24:118–24.
    1. Gill-Body KM, Beninato M, Krebs DE. relationship among balance impairments, functional performance, and disability in people with peripheral vestibular hypofunction. Phys Ther. (2000) 80:748–58. 10.1093/ptj/80.8.748
    1. Jacobson GP, Newman CW, Hunter L, Balzer G. Balance function test correlates of the dizziness handicap inventory. J Am Acad Audiol. (1991) 2:253–60. 10.1037/t35080-000
    1. Rossi-Izquierdo M, Santos-Pérez S, Faraldo-García A, Vaamonde-Sánchez-Andrade I, Gayoso-Diz P, Del-Río-Valeiras M, et al. . Impact of obesity in elderly patients with postural instability. Aging Clin Exp Res. (2016) 28:423–8. 10.1007/s40520-015-0414-4
    1. Franco-Gutiérrez V, Rossi-Izquierdo M, Franco-Gutiérrez R, Santos-Pérez S, Faraldo-García A, del Río-Valeiras M, et al. . Does patient environment have any influence on balance? Aging Clin Exp Res. (2020) 32:645–53. 10.1007/s40520-019-01247-x

Source: PubMed

Спонсоры и соавторы

Заболевания

Медикаментозные вмешательства

Подписаться