Effect of age on treatment outcomes in benign paroxysmal positional vertigo: A systematic review

Abstract

Background: Benign paroxysmal positional vertigo (BPPV) can lead to an increased fall risk in older adults. Therefore, we examined the influence of age on the effectiveness of canalith-repositioning procedures (CRPs) for the treatment of BPPV.Methods: Pubmed, Web of Science, and the bibliographies of selected articles were searched for studies conducted before September 2020 that examined the effectiveness of treatments for BPPV in various age groups. Meta-analyses were performed to compare treatment effectiveness and recurrence rates for younger and older adults. Odds ratios were calculated in a random-effects model. Mean differences were calculated using a fixedeffects model. A significance level of p < 0.05 (95% confidence interval) was set. The risk of bias and the methodological quality of all included articles were examined.Results: Forty-five studies were retrieved after full-text screening, of which 29 studies were included for a qualitative review. The remaining 16 studies were eligible for inclusion in the meta-analysis (3267 participants with BPPV).The success rate of a single CRP was higher in the younger group (72.5% vs. 67%, p < 0.001). An average of 1.4 and 1.5 CRPs was needed for complete recovery in the younger and older groups, respectively (p = 0.02). However, global treatment success did not differ between these groups (97.5% vs. 94.6%, p = 0.41). The recurrence rate was higher in the older population (23.2% vs. 18.6%, p = 0.007).Conclusions: Although more CRPs are needed, the rate of complete recovery in older adults is similar to that observed in younger adults.

Outcome for dizzy patients in a physiotherapy practice: an observational study

“…This multiplicative nature indicates that increasing age is a factor to be taken into account when evaluating a patient's prognosis. This is in line with a systematic review that showed that older adults with BPPV require more repositioning manoeuvres to obtain treatment success [ 35 ]. In patients with BPPV, the prognostic model contained also ‘concomitant neck pain’ with an OR of 4.42 and ‘provocation of the dizziness by movements in the horizontal plane’ with an OR of 0.25.…”

Feasibility of an inertial measurement unit sensor-based guiding system for benign paroxysmal positional vertigo treatment: A pilot study

“…(2) Younger participants have less difficulty learning geometrically complex 3-D head movements 8 . (3) Recurrence and residual symptoms requiring additional management are more frequent in elderly participants [26][27][28] . Although clinically irrelevant, the study results may change if young participants were exclusively recruited.…”

Geriatric benign paroxysmal positional vertigo: a single-center study

“… 6 Furthermore, elderly patients often arrive to hospital late, have a longer duration of illness, and are likely to have chronic comorbidities, such as hypertension, diabetes, and osteoporosis, which may be risk factors for BPPV and have a significant effect on their clinical presentation and prognosis. Previous studies 7 have shown that the Canalith Repositioning Procedure (CRP) is less effective in elderly patients with BPPV than in younger patients. Moreover, the incidence of residual symptoms after a CRP, such as prolonged episodes of dizziness and unsteadiness, increases significantly with advancing age.…”