Email updates

Keep up to date with the latest news and content from BMC Geriatrics and BioMed Central.

Open Access Research article

Vestibular asymmetry predicts falls among elderly patients with multi- sensory dizziness

Eva Ekvall Hansson1* and Måns Magnusson2

Author Affiliations

1 Department of Clinical Sciences in Malmö/Family Medicine, Lund University, Jan Waldenströms gata 35, SE 205 02, Malmö, Sweden

2 Department of Clinical Sciences in Lund/ENT, Lund University, Skåne University Hospital, Lasarettsgatan 21, SE 222 85, Lund, Sweden

For all author emails, please log on.

BMC Geriatrics 2013, 13:77  doi:10.1186/1471-2318-13-77

Published: 22 July 2013

Abstract

Background

Dizziness is the most common symptom in elderly patients and has been identified as a risk factor for falls. While BPPV is the most common cause of dizziness among elderly, multisensory deficits is the second, with visual, vestibular and proprioceptive reduced function. Asymmetric vestibular function is overrepresented in elderly persons with hip fractures and wrist fractures and can be accessed for screening.

The objective was to study if vestibular asymmetry, vibration sense, balances performance, postural sway in quiet stance and self-perceived handicap because of dizziness could predict falls among elderly, dizzy patients.

Methods

In this prospective study with one year observation period, 55 patients (41 women, 14 men), 65 to 90 years old (median 80, interquartile range 11) with multisensory dizziness were included.

Vestibular function was screened with the headshake test and vibration sense was assessed using a tuning fork. Balance was assessed with four clinical measures and self-perceived dizziness handicap was assessed by the Dizziness Handicap Inventory. Postural sway was measured using a force plate.

Results

Headshake test were pathologic in 24 patients, which substantially increased the risk of falls (OR 3.4). Thirteen of the 21 patients who had fallen (p = 0.03), and all 6 patients who sustained three falls or more (p = 0.04), had vestibular asymmetry. No other measure could predict the risk of falls (OR 0.55–1.71).

Conclusion

Signs of vestibular asymmetry among elderly with multisensory dizziness could predict falls. Hence, it seems important to address fall-prevention programs to such a group of patients. Simple bedside tests of vestibular asymmetry might be a possibility to screen for one risk factor for falls among elderly.

Keywords:
Dizziness; Vestibular asymmetry; Falls; Prospective