Vestibular Loss in Older Adults Is Associated with Impaired Spatial Navigation: Data from the Triangle Completion Task

Abstract

BackgroundVestibular inputs have been shown to play a critical role in spatial navigation. In this study, we sought to evaluate whether vestibular loss due to aging contributes to impaired spatial navigation as measured by the triangle completion task (TCT).Materials and methodsWe recruited three types of participants: young controls <55 years of age, older controls ≥55 years of age, and older patients from a Neurotology Clinic with evidence of vestibular physiologic impairment but who did not have any known vestibular disorder. We performed the cervical vestibular-evoked myogenic potential to evaluate saccular function and video head impulse testing to quantify horizontal semicircular canal vestibulo-ocular reflex gain. To assess spatial navigation ability, we administered the TCT, in which participants were conveyed along two segments of a pre-drawn triangular path and instructed to complete the final segment independently. We measured the angle (degrees) and distance (centimeters) of deviation from the correct trajectory. We evaluated the influence of vestibular inputs on TCT performance.ResultsForty-eight adults participated in the study (mean age: 62.0 years; 52.1% females), including 9 young controls, 15 older controls, and 24 clinic patients. Clinic patients had the greatest distance of deviation (67.7 cm), followed by older controls (45.4 cm), then young controls (27.8 cm; p < 0.01). Similarly, clinic patients had greater rotational angles (22.1°) compared to older (13.3°) and younger controls (12.4°; p < 0.01). Following multivariate linear regression adjusting for demographic variables, loss of otolith function was associated with an 18.2 cm increase in distance of deviation (95% CI: 15.2–47.4) and a 9.2° increase in rotational angle (95% CI: 3.0–15.5). Abnormal semicircular canal function was associated with a 26.0 cm increase in distance of deviation (95% CI: 0.2–51.8) and a 10.8° increase in rotational angle (95% CI: 3.0–15.5). Participants with both otolith and canal abnormalities had a larger distance error (β = 25.3, 95% CI: 6.2–44.4) and angle of deviation (β = 18.1, 95% CI: 10.1–26.2) than with either condition alone.ConclusionVestibular loss in older adults was associated with poorer performance on a dynamic spatial navigation task relative to old and young controls.

Vestibular Dysfunction and Difficulty with Driving: Data from the 2001–2004 National Health and Nutrition Examination Surveys

“…One recent study in community-dwelling adults found a significant association between vestibular function and tests of visuospatial cognitive ability ( 4 ). Studies using the triangle completion task (TCT) have shown that vestibular function (both otolith and canal) contributes to performance on a dynamic spatial navigation task ( 5 , 6 ). Furthermore, patients with bilateral vestibular loss were shown to have lower hippocampal volumes and impaired spatial memory and navigation as assessed with a virtual maze test ( 7 ).…”

Presbyvestibulopathie

“…Objektive Messergebnisse zu Ganganomalien sind die Ganggeschwindigkeit, das Tandemgehen und Indizes wie der Dynamic-Gait-Index und die funktionelle Gangbeurteilung [86]. Schwindelbedingte Behinderungen können beispielsweise mit Patienten-Fragebögen wie dem Dizziness Handicap Inventory genauer ermittelt werden [87]. Stürze können auf der Basis der Anzahl der Stürze in einem bestimmten Zeitraum quantifiziert oder anhand von Patienten-Fragebögen wie dem Falls Efficacy Scale [88] näher bestimmt werden.…”

Sources of path integration error in young and aging humans

“…Recent evidence from neuroimaging studies indicates that signatures of grid-cell-like activity in human entorhinal cortex are reduced in old age, and this reduction is associated with larger path integration errors (Stangl et al, 2018). Certain aspects of the vestibular system also deteriorate with age (for a review, see Allen et al, 2016), and vestibular loss affects path integration performance (Glasauer et al, 2002;Xie et al, 2017). These findings support the possibility that an increase in noise on a neuronal level, possibly from a loss of the signal-to-noise ratio from degrading circuitry in the grid cell or the vestibular system may be responsible for deficient computations of pose in old age.…”