Age-related Patterns of Vestibular Dysfunction in Dizziness and Imbalance: A Review of Vestibular Testing Results Among 1,116 Patients.

Journal Article (Journal Article)

OBJECTIVE: To characterize differences in vestibular testing results among patients presenting with balance-related complaints; to stratify patterns of testing abnormalities by age. STUDY DESIGN: Retrospective chart review. SETTING: Academic Balance Center at a Tertiary Referral Center. PATIENT POPULATION: All patients who underwent vestibular testing in a 1-year period from 2017 to 2018. MAIN OUTCOME MEASURE: Balance function test results. RESULTS: We reviewed 1,116 patients with age ranging from 11 to 94 years, including 521 patients ≥60 years. Most patients had at least 1 abnormal result, with only 21% of patients ≥60 years and 43% of patients <60 years yielding no test abnormalities (p < 0.001). Among 754 individuals with abnormal testing results, caloric testing did not show any significant difference between age groups. Patients ≥60 years of age were more likely to demonstrate abnormalities on saccadic and horizontal tracking eye movements (p < 0.01; sacc 20.8% vs 6.3%; HT 9.2% vs 4.7%), as well as positional and Dix-Hallpike testing with videonystagmography (p < 0.001; pos 52.3% vs 37.5%, DH 14.4% vs 6.8%). On computerized dynamic posturography, there were significantly more abnormal composite scores in the older group for both sensory organization and motor control testing (p < 0.001; SOT 31.8% vs 8.8%, MCT 7.6% vs 1.8%). CONCLUSION: Among patients presenting balance-related complaints, a majority demonstrate at least one abnormality on vestibular testing. While caloric abnormalities occur across the life span, patients ≥60 years of age are more likely to have abnormal results in random saccades, positional, Dix-Hallpike testing, and posturography, with greater effect sizes in tests of central function. While the causes of imbalance and vertigo remain multifactorial, vestibular dysfunction can be considered a major contributor to balance dysfunction in the elderly population and should be thoroughly evaluated.

Full Text

Duke Authors

Cited Authors

  • Nimmo, ZM; Hwa, TP; Naples, JG; Shah, R; Brant, JA; Eliades, SJ; Bigelow, DC; Ruckenstein, MJ

Published Date

  • July 1, 2021

Published In

Volume / Issue

  • 42 / 6

Start / End Page

  • 897 - 905

PubMed ID

  • 34111051

Electronic International Standard Serial Number (EISSN)

  • 1537-4505

Digital Object Identifier (DOI)

  • 10.1097/MAO.0000000000003094


  • eng

Conference Location

  • United States