Health‐related quality of life and economic burden of vestibular loss in older adults

Agrawal, Yuri; Pineault, Kevin; Semenov, Yevgeniy R.

doi:10.1002/lio2.129

Cited by 52 publications

(33 citation statements)

References 37 publications

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“…Agrawal et al / Presbyvestibulopathy: Diagnostic criteria about the consequences of aging of the human sensory systems on individual and public health [1]. Age-related vision loss (due to age-related loss of lens accommodation or "presbyopia," cataracts, or macular degeneration) has been associated with increased risks of disability, falls, and institutionalization [2][3][4]. Age-related hearing loss (or presbycusis) has been associated with increased risks of dementia, depression, and mortality [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Presbyvestibulopathy: Diagnostic criteria Consensus document of the classification committee of the Bárány Society

Agrawal

Berg

Wuyts

et al. 2019

VES

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This paper describes the diagnostic criteria for presbyvestibulopathy (PVP) by the Classification Committee of the Bárány Society. PVP is defined as a chronic vestibular syndrome characterized by unsteadiness, gait disturbance, and/or recurrent falls in the presence of mild bilateral vestibular deficits, with findings on laboratory tests that are between normal values and thresholds established for bilateral vestibulopathy. The diagnosis of PVP is based on the patient history, bedside examination and laboratory evaluation. The diagnosis of PVP requires bilaterally reduced function of the vestibulo-ocular reflex (VOR). This can be diagnosed for the high frequency range of the VOR with the video-HIT (vHIT); for the middle frequency range with rotary chair testing; and for the low frequency range with caloric testing. For the diagnosis of PVP, the horizontal angular VOR gain on both sides should be < 0.8 and > 0.6, and/or the sum of the maximal peak velocities of the slow phase caloric-induced nystagmus for stimulation with warm and cold water on each side should be < 25 • /s and > 6 • /s, and/or the horizontal angular VOR gain should be > 0.1 and < 0.3 upon sinusoidal stimulation on a rotatory chair. PVP typically occurs along with other age-related deficits of vision, proprioception, and/or cortical, cerebellar and extrapyramidal function which also contribute and might even be required for the manifestation of the symptoms of unsteadiness, gait disturbance, and falls. These criteria simply consider the presence of these symptoms, along with documented impairment of vestibular function, in older adults.

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Section: Introductionmentioning

confidence: 99%

Presbyvestibulopathy: Diagnostic criteria Consensus document of the classification committee of the Bárány Society

Agrawal

Berg

Wuyts

et al. 2019

VES

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150

117

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“…Mit Video-KIT gemessener VOR-Gain bilateral zwischen 0,6 und 0,8 1 , 2. VOR-Gain zwischen 0,1 und 0,3 bei Drehstuhlpendelung (0,1 Hz, Vmax = 50-60°/s) 2 , 3. verminderte kalorische Reaktion (Summe der bithermalen maximalen Spitzen-SPV (Slow Phase Velocity) auf jeder Seite zwischen 6 und 25°/s) 3,4 .…”

Section: B Leichte Bilaterale Periphere Vestibuläre Hypofunktion Beunclassified

“…Das Bewusstsein für die Folgen des Alterns der menschlichen Sinnesorgane für die individuelle und die öffentliche Gesundheit wächst [1]. Altersbedingter Sehverlust (aufgrund von altersbedingtem Verlust der Nahanpassungsfähigkeit (Presbyopie), Katarakt oder Makuladegeneration) ist mit einem erhöhten Risiko von Behinderungen, Stürzen und der Unterbringung in Pflegeheimen assoziiert worden [2][3][4]. Altersbedingter Hörverlust (Presbyakusis) ist mit einem erhöhten Risiko für Demenz, Depression und Mortalität assoziiert [5][6][7].…”

Section: Introductionunclassified

Presbyvestibulopathie

Berg¹,

Wuyts²,

Walther³

et al. 2020

Nervenheilkunde

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ZusammenfassungIn dieser Publikation werden die Diagnosekriterien für Presbyvestibulopathie (PVP) durch das Klassifikationskomitee der Bárány-Gesellschaft beschrieben. PVP ist als ein chronisches vestibuläres Syndrom definiert, das durch Gangunsicherheit, Gangstörungen und/oder wiederholte Stürze bei leichten bilateralen vestibulären Defiziten gekennzeichnet ist, mit Labortestbefunden, die zwischen Normalwerten und Schwellenwerten für die bilaterale Vestibulopathie liegen.Die Diagnose von PVP basiert auf der Anamnese des Patienten, der körperlichen Untersuchung des Patienten und der Auswertung von Untersuchungen des Gleichgewichtssystems. Die Diagnose von PVP setzt eine bilateral verminderte Funktion des vestibulookulären Reflexes (VOR) voraus. Dies kann für den Hochfrequenzbereich des VOR mit dem Video-Kopf-Impuls-Test (vKIT), für den mittleren Frequenzbereich mit dem Drehstuhltest und für den Niederfrequenzbereich mit der kalorischen Prüfung diagnostiziert werden.Für die Diagnose von PVP sollte der horizontale anguläre VOR-Verstärkungsfaktor (Gain) auf beiden Seiten < 0,8 und > 0,6 betragen, und/oder die Summe der maximalen Spitzengeschwindigkeiten in der langsamen Phase des kalorisch induzierten Nystagmus sollte bei der Stimulation mit warmem und kaltem Wasser auf jeder Seite < 25°/s und > 6°/s betragen, und/oder der horizontale anguläre VOR-Gain sollte bei Drehstuhlpendelung > 0,1 und < 0,3 betragen.PVP tritt typischerweise zusammen mit anderen altersbedingten Defiziten des Sehvermögens, der Propriozeption und/oder der kortikalen, zerebellären und extrapyramidalen Funktion auf, die ebenfalls zur Manifestation der Symptome von Gangunsicherheit, Gangstörungen und Stürzen beitragen und diese möglicherweise erst auftreten lassen. Die hier beschriebenen Kriterien berücksichtigen lediglich das Vorhandensein dieser Symptome zusammen mit einer dokumentierten Beeinträchtigung der vestibulären Funktion bei älteren Erwachsenen.

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“…Of particular interest was the number of respondents working in care of the elderly settings (43.3%). Vestibular disorders are very frequent and problematic in older individuals [1]. Presbyvestibulopathy [27], recently defined by the Bárány Society as a chronic vestibular syndrome with mild bilateral vestibular deficits, is likely to be ameliorated with VR.…”

Section: Discussionmentioning

confidence: 99%

Vestibular rehabilitation in Europe: a survey of clinical and research practice

et al. 2020

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Vestibular rehabilitation (VR) is practiced across Europe but little in this area has been quantified. The aim of this study was to investigate current VR assessment, treatment, education, and research practices. This was an online, cross-sectional survey with 39 VR specific questions and four sections: demographics, current practice, education, and research. The survey was disseminated through the Dizzynet network to individual therapists through country-specific VR special interest groups. Results were analysed descriptively. A thematic approach was taken to analyse open questions. A total of 471 individuals (median age 41, range 23 − 68 years, 73.4% women), predominately physiotherapists (89.4%) from 20 European countries responded to the survey. They had worked for a median of 4 years (range < 1 − 35) in VR. The majority (58.7%) worked in hospital in-patient or out-patient settings and 21.4% in dedicated VR services. Most respondents specialized in neurology, care of the elderly (geriatrics), or otorhinolaryngology. VR was reported as hard/very hard to access by 48%, with the main barriers to access identified as lack of knowledge of health care professionals (particularly family physicians), lack of trained therapists, and lack of local services. Most respondents reported to know and treat benign paroxysmal positional vertigo (BPPV 87.5%), unilateral vestibular hypofunction (75.6%), and cervicogenic dizziness (63%). The use of vestibular assessment equipment varied widely. Over 70% used high-density foam and objective gait speed testing. Over 50% used dynamic visual acuity equipment. Infrared systems, Frenzel lenses, and dynamic posturography were not commonly employed (< 20%). The most frequently used physical outcome measures were the Clinical Test of the Sensory Interaction of Balance, Functional Gait Assessment/Dynamic Gait Index, and Romberg/Tandem Romberg. The Dizziness Handicap Inventory, Visual Analogue Scale, Falls Efficacy Scale, and the Vertigo Symptom Scale were the most commonly used patient reported outcome measures. Adaptation, balance, and habituation exercises were most frequently used (> 80%), with virtual reality used by 15.6%. Over 70% reported knowledge/use of Semont, Epley and Barbeque-Roll manoeuvres for the treatment of BPPV. Most education regarding VR was obtained at post-registration level (89.5%) with only 19% reporting pre-registration education. There was strong (78%) agreement that therapists should have professionally accredited postgraduate certification in VR, with blended learning the most popular mode. Three major research questions were identified for priority: management of specific conditions, effectiveness of VR, and mechanisms/factors influencing vestibular compensation and VR. In summary, the survey quantified current clinical practice in VR across Europe. Knowledge and treatment of common vestibular diseases was high, but use of published subjective and objective outcome measures as well as vestibular assessment varied widely. The results stress the need of improving both training of therapists and standards of care. A European approach, taking advantage of best practices in some countries, seems a reasonable approach.

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Health‐related quality of life and economic burden of vestibular loss in older adults

Cited by 52 publications

References 37 publications

Presbyvestibulopathy: Diagnostic criteria Consensus document of the classification committee of the Bárány Society

Presbyvestibulopathy: Diagnostic criteria Consensus document of the classification committee of the Bárány Society

Presbyvestibulopathie

Vestibular rehabilitation in Europe: a survey of clinical and research practice

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