Prevalence of Vestibular Dysfunction with Presbycusis among Elderly in Malaysia

Objectives: This study aims to determine the prevalence of vestibular dysfunction in the Malaysian elderly and its association with presbycusis, age and other associated risk factors. Methods: A cross-sectional study was undertaken in a tertiary otorhinolaryngology department and the community. Adults aged 60 years and above who attended the ORL CLINIC with or without presbycusis were invited to participate. The main outcome measures, including the Malay Version Vertigo Symptoms Scale, pure tone audiometry and vestibular assessment, were obtained using a Video Head Impulse Test (VHIT). Results: The prevalence of vestibular dysfunction with presbycusis in the study population of 135 participants was 46.7 per cent (95 per cent confidence interval, 24.0 to 36.2 per cent). The median age was 68 years (range, 60–86 years). The A chi-square test of independence showed that there was significant association between Presbycusis and Tinnitus, X2 (1, N = 135) = 97.37, p < .001. A chi-square test of independence was performed to examine the relation between presbycusis and dizziness. The relation between these variables was significant, X2 (2, N = 135) = 28.42, p < .001. A chi-square test of independence showed that there was no significant association between presbycusis and VHIT, X2 (1, N = 135) = .01, p = .938. Conclusion: Vestibular dysfunction is independently associated with ageing and presbycusis. More research investigating the advantages of additional screening for vestibular dysfunction in older presbycusis patients is needed. Key words: Elderly; Presbycusis; Vestibular dysfunction; Video Head Impulse Test (VHIT)

Age-Related Vestibular Dysfunction; Vestibulo-Ocular Reflex, Dynamic Visual Acuity, Dizziness and Falls: A Review

Background: Vestibular and vision functions are important contributors to posture control and fall avoidance. This review examines how the vestibulo-ocular reflex can be rehabilitated to help restore postural control. Methods: PubMed searches (7th April 2021) using the terms ‘vestibulo-ocular reflex’, ‘imbalance and vestibular dysfunction’, ‘vestibular dysfunction and dizziness’, ‘dynamic visual acuity’, ‘vestibular dysfunction rehabilitation’, and ‘gaze stabilization exercises’ yielded 4986, 495, 3576,1830, 3312, and 137 potentially useful publications respectively. Selections of those which were found to be the most relevant and representative of a balanced and current account of these topics, as well as selections from the most relevant reports referenced in those publications, were included in this review. Results: Just as there are age-related losses of static visual acuity even when there are no specific visual pathologies diagnosed, patients may also present with age-related loss of vestibular functions in the absence of specific vestibular pathologies. For example, cases of dizziness which are diagnosed as idiopathic might be usefully classified as age-related as the basis for the initiation of rehabilitation exercises. Conclusions: Apart from age-related loss of vestibular functions, cases diagnosed as having a particular form of vestibular pathology may have that condition exacerbated by age-related losses of vestibular functions. The effects of vestibular rehabilitation gaze stability exercises in patients with vestibular dysfunction are well established and include both improved dynamic acuity and postural stability. Improvements in posture control following rehabilitation of the vestibulo-ocular reflex are apparently due to improved peripheral and/or central vestibular balance control which has occurred in conjunction with enhanced gaze stability. The complex nature of increased fall risk suggests that an interdisciplinary approach to rehabilitation that includes vestibulo-ocular reflex rehabilitation appears likely to be associated with optimum outcomes for both pathological and age-related cases.

Experimental hydrops of labyrinth

Difficulties in approbation of drugs for the treatment of vestibular dysfunction are associated with a lack of knowledge of the mechanisms of its development. In particular, it is necessary to take into account the initial state of the vestibular analyzer, which significantly affects the research results. Therefore, the modeling of pathological processes that manifest in vestibular dysfunction is the optimal method for studying both its mechanisms and the effectiveness of medications for its relief. Endolymphatic hydrops is found in most diseases manifested by peripheral vestibular syndrome. We have proposed several models of endolymphatic hydrops in rats to study various aspects of its pathogenesis and approbate means of treating vestibular dysfunction.

STABILOMETRIC DIAGNOSIS OF VERTIGO IN ELDERLY PATIENTS WITH VESTIBULAR MIGRAINE

Цель исследования - изучение возможности компьютерной стабилометрической диагностики для объективизации головокружения у пожилых пациентов с вестибулярной мигренью. В исследование были включены 57 пожилых пациентов с вестибулярной мигренью и 57 пожилых пациентов с центральным вестибулярным головокружением без мигрени. Для объективизации головокружения применяли специализированные тесты функциональной компьютерной стабилометрии. Проведенное исследование позволило выявить особенности базовых стабилометрических параметров в специализированных тестах у пожилых пациентов, которые можно использовать для получения количественной оценки вестибулярной дисфункции и объективизации головокружения. The purpose of the study was to study the possibility of computer stabilometric diagnostics for the objectification of vertigo in elderly patients with vestibular migraine. The study included 57 elderly patients with vestibular migraine and 57 elderly patients with central vestibular vertigo, without migraine. Specialized tests of functional computer stabilometry were used to objectify vertigo. The study revealed the features of the basic stabilometric parameters in specialized tests in elderly patients, which can be used to obtain a quantitative assessment of vestibular dysfunction and objectification of vertigo.