Risk of falls, vestibular multimodal processing, and multisensory integration decline in the elderly–Predictive role of the functional head impulse test

Abstract

Age-related degeneration of the vestibular system, also known as presbyastasis, leads to unstable gait and higher risk of falls. These conditions affect lifestyle and may have non-negligible social repercussions due to fear-related states of anxiety and depression. In order to develop a model for predicting risk of falls, we assessed vestibulo-ocular function by video and functional Head Impulse Tests (vHIT and fHIT) and their possible correlations with Tinetti Balance Test score. Thirty-one patients over 65 years of age admitted with trauma due to falls were recruited. Vestibular evaluation (complete otoneurological assessment, vHIT, fHIT), cognitive tests (Mini Mental State Examination), anxiety and depression evaluation and Tinetti Balance Test were performed. The possibility of a correlation between the head impulse tests (vHIT, fHIT) and the Tinetti Balance Test was investigated by logistic regression analysis (Nagelkerke r2 and Wald test). A linear correlation was found between the Tinetti Balance Test score and fHIT, whereas no correlation was found for vHIT. Functional HIT is an effective test for predicting the risk of falls in elderly patients.

Vertigo in the Elderly: A Systematic Literature Review

“…The test evaluates the ability to accurately recognize a picture that is quickly displayed during VOR activation. A recent study demonstrated that, when the multisensory integration deteriorates (i.e., fHIT scores lower than 80%), the risk of fall increases 3.9 times [ 27 ].…”

Role of the functional head impulse test in evaluating vestibulo‐ocular reflex abnormalities in individuals with Parkinson's disease

“…While normal findings are obtained with vHIT, abnormal results may be seen with fHIT. The most likely reason for it is that the identification of the C optotype presented in fHIT depends not only on an intact VOR but also on the integration of vestibular, visual and cortical information 17 and therefore it is likely to be less specific for vestibular abnormalities. Moreover, ocular abnormalities can affect test results in fHIT.…”

The Effect of Presbiastasis on Adaptation Score, Fear of Falling and Quality of Life

“…Düşme hikâyesi olmayan grupta adaptasyon skorlarının daha iyi olduğu görüldü. 19 Soto-Varela ve ark.nın yapmış olduğu çalışmada son bir yıl içinde en az bir kez düşmüş yaşlı bireylerle düşme hikâyesi olmayan yaşlı bireylerin Duyu Organizasyon Testi (DOT) ve DEÖ skorları karşılaştırılmıştır. 13 Düşmüş olanlar, Koşul 2'de (p=0,043) ve somatosensöriyel bilgi kullanımında (p=0,039) düşmeyenlere göre daha kötü skorlar elde etmiştir.…”