Association Between Saccular Function and Gait Speed

Layman, Andrew J.; Li, Carol; Simonsick, Eleanor M.; Ferrucci, Luigi; Carey, John P.; Agrawal, Yuri

doi:10.1097/mao.0000000000000544

Cited by 38 publications

(26 citation statements)

References 30 publications

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“…First, we found that difficulty walking was universally reported by the older participants in the study. The current literature on vestibular function and walking is relatively sparse, with small studies showing an association between vestibular loss and slower gait speeds and between vestibular loss and shorter step lengths [5, 6]. A more comprehensive understanding of the link between vestibular impairment and gait speed and variability in older individuals is warranted, given the universality of this symptom.…”

Section: Discussionmentioning

confidence: 99%

Understanding the Experience of Age-Related Vestibular Loss in Older Individuals: A Qualitative Study

Harun¹,

Li²,

Bridges

et al. 2016

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Background Inner ear balance (or vestibular) function declines with age and is associated with decreased mobility and an increased risk of falls in older individuals. We sought to understand the lived experience of older adults with vestibular loss in order to improve care in this population. Methods Qualitative data were derived from semi-structured interviews of individuals aged 65 years or older presenting to the Balance and Falls Prevention Clinic from February 1, 2014 to March 30, 2015 for evaluation of age-related vestibular loss. Transcripts were analyzed using interpretive phenomenological analysis. We created a taxonomy of overarching superordinate themes based on the World Health Organization's International Classification of Functioning, Disability, and Health (ICF) Framework, and classified key dimensions within each of these themes. Results Sixteen interviews were conducted with individuals (mean age 76.0 years, 75 % female) with age-related vestibular loss. The three superordinate themes and associated key dimensions were (1) body impairment (including depression, fatigue, fear/anxiety, and problems with concentrating and memory); (2) activity limitation and participation restriction (isolation, needing to stop in the middle of activities, reduced participation relative to expectations, reduced ability to drive or travel, and problems with bending/looking up, standing, and walking); and (3) environmental influences (needing help with daily activities). All participants reported difficulty walking. Conclusions Older adults report that vestibular loss impacts their body functioning and restricts their participation in activities. The specific key dimensions uncovered by this qualitative study can be used to evaluate care from the patient's perspective.

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Section: Discussionmentioning

confidence: 99%

Understanding the Experience of Age-Related Vestibular Loss in Older Individuals: A Qualitative Study

Harun¹,

Li²,

Bridges

et al. 2016

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“…This increase has been reported for click and tone burst stimulations ( 12 ). Though the majority of studies report no significant effect of age on cVEMP latencies ( 19 , 31 , 33 , 35 ), few authors have observed age-related increased latency on the p13 ( 15 , 34 ) and n23 ( 9 ), while other have reported age-related decreases to n23 ( 24 ). cVEMP response rates are widely reported to decrease with age.…”

Section: Effects Of Aging and Vestibular Evaluation Techniquesmentioning

confidence: 95%

“…Numerous studies have reported a decrease in oVEMP amplitude related to age ( 19 , 29 , 31 , 33 , 35 – 37 ). More specifically, oVEMP amplitude has been reported to decrease by 2.9 μV per decade, independent of the stimulus used ( 19 , 29 , 31 , 33 , 36 , 37 ). Normal aging has been reported to increase oVEMP thresholds ( 12 ).…”

Section: Effects Of Aging and Vestibular Evaluation Techniquesmentioning

confidence: 99%

“…Normal aging has been reported to increase oVEMP thresholds ( 12 ). Most studies report significant increases in oVEMP latency with age ( 19 , 31 , 33 , 36 , 37 ). This increase has been reported to be significant after 60 years of age ( 36 ) and at a rate of 0.12 ms per decade ( 31 ).…”

Section: Effects Of Aging and Vestibular Evaluation Techniquesmentioning

confidence: 99%

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The Effects of Aging on Clinical Vestibular Evaluations

et al. 2015

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Balance disorders are common issues for aging populations due to the effects of normal aging on peripheral vestibular structures. These changes affect the results of vestibular function evaluations and make the interpretation of these results more difficult. The objective of this article is to review the current state of knowledge of clinically relevant vestibular measures. We will first focus on otolith function assessment methods cervical-VEMP (cVEMP) and ocular-VEMP (oVEMP), then the caloric and video-head impulse test (vHIT) methods for semicircular canals assessment. cVEMP and oVEMP are useful methods, though research on the effects of age for some parameters are still inconclusive. vHIT results are largely independent of age as compared to caloric stimulation and should therefore be preferred for the evaluation of the semicircular canals function.

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“…23 We also previously reported an association between saccular dysfunction and slower walking speed among older women, but not older men. 24 The peripheral vestibular system senses head movements and responds to high-frequency head oscillations that occur during walking. 25–26 Vestibular information is also used to stabilize the head and trunk and serves both a postural and gaze stability purpose.…”

Section: Discussionmentioning

confidence: 99%

Age-Related Imbalance Is Associated With Slower Walking Speed: An Analysis From the National Health and Nutrition Examination Survey

Xie

Liu

Anson

et al. 2017

Journal of Geriatric Physical Therapy

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Background and purpose Walking speed is an important dimension of gait function and is known to decline with age. Gait function is a process of dynamic balance and motor control that relies on multiple sensory inputs (e.g. visual, proprioceptive and vestibular) and motor outputs. These sensory and motor physiologic systems also play a role in static postural control, which has been shown to decline with age. In this study, we evaluated whether imbalance that occurs as part of healthy aging is associated with slower walking speed in a nationally-representative sample of older adults. Methods We performed a cross-sectional analysis of the previously collected1999–2002 National Health and Nutrition Examination Survey (NHANES) data to evaluate whether age-related imbalance is associated with slower walking speed in older adults aged 50 to 85 (n=2,116). Balance was assessed on a pass/fail basis during a challenging postural task—Condition 4 of the modified Romberg test, and walking speed was determined using a 20-feet (6.10 m) timed walk. Multivariable linear regression was used to evaluate the association between imbalance and walking speed, adjusting for demographic and health-related covariates. A structural equation model was developed to estimate the extent to which imbalance mediates the association between age and slower walking speed. Results In the unadjusted regression model, inability to perform the NHANES balance task was significantly associated with 0.10 m/s slower walking speed (95% confidence interval [CI]: −0.13, −0.07; p<0.01). In the multivariable regression analysis, inability to perform the balance task was significantly associated with 0.06 m/s slower walking speed (95% CI: −0.09, −0.03; p<0.01), an effect size equivalent to 12 years of age. The structural equation model estimated that age-related imbalance mediates 12.2% of the association between age and slower walking speed in older adults. Conclusion In a nationally-representative sample, age-related balance limitation was associated with slower walking speed. Balance impairment may lead to walking speed declines. Additionally, reduced static postural control and dynamic walking speed that occur with aging may share common etiologic origins, including the decline in visual, proprioceptive, and vestibular sensory and motor functions.

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Association Between Saccular Function and Gait Speed

Cited by 38 publications

References 30 publications

Understanding the Experience of Age-Related Vestibular Loss in Older Individuals: A Qualitative Study

Understanding the Experience of Age-Related Vestibular Loss in Older Individuals: A Qualitative Study

The Effects of Aging on Clinical Vestibular Evaluations

Age-Related Imbalance Is Associated With Slower Walking Speed: An Analysis From the National Health and Nutrition Examination Survey

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