Prevalence and impact of bilateral vestibular hypofunction: results from the 2008 US National Health Interview Survey.
OBJECTIVE
Profound bilateral vestibular hypofunction (BVH) causes disabling oscillopsia, chronic disequilibrium, and postural instability, but little is known about its epidemiology and impact.


OBJECTIVE
To assess prevalence and functional impact of BVH in the US adult population.


METHODS
National cross-sectional survey using a national database and corollary validation study.


METHODS
Adult respondents to the 2008 Balance and Dizziness Supplement to the US National Health Interview Survey (N = 21 782).


METHODS
Prevalence of BVH, socioeconomic and quality-of-life impact of BVH, and fall risk. Criteria for the survey-based diagnosis of BVH included all of the following: presence of visual blurring with head movement; unsteadiness; difficulty walking in darkness or unsteady surfaces and in a straight path; and symptoms being at least "a big problem" and present for at least 1 year, in the absence of other neurologic conditions or eye pathologic conditions affecting vision.


RESULTS
Adjusted national estimates from this survey indicate the prevalence of BVH in 2008 was 28 per 100 000 US adults (64 046 Americans). Of the participants with BVH, 44% reported changing their driving habits because of their symptoms, 56% reported reduced participation in social activities, and 58% reported difficulties with activities of daily living. Respondents with BVH had a 31-fold increase in the odds of falling in multivariate analyses compared with all respondents, with 25% reporting a recent fall-related injury.


CONCLUSIONS
As estimated by the presence of specific symptoms in a nationally representative survey, BVH has considerable socioeconomic and quality-of-life impacts and significantly increases fall risk. These data support the need for new therapeutic strategies for BVH, including vestibular rehabilitation and implantable vestibular prostheses.
Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA. bward15@jhmi.edu
Bryan K
BK
Ward
Yuri
Y
Agrawal
Howard J
HJ
Hoffman
John P
JP
Carey
Charles C
CC
Della Santina
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D004244:Dizziness / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D004856:Postural Balance; D015995:Prevalence; D011788:Quality of Life; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D018434:Sickness Impact Profile; D014481:United States / Q000453:epidemiology; D014717:Vertigo / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D015837:Vestibular Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D014786:Vision Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D055815:Young Adult