title: Peripheral vestibular dysfunction is prevalent in older adults experiencing multiple non-syncopal falls versus age-matched non-fallers: a pilot study.
abstract: BACKGROUND
  vestibular disorders are common in the general population, increasing with age. However, it is unknown whether older adults who fall have a higher proportion of vestibular impairment compared with age-matched older adult non-fallers.
  
  
  OBJECTIVE
  to identify whether a greater proportion of older adult fallers have a peripheral vestibular impairment compared with age-matched healthy controls.
  
  
  METHODS
  case-controlled study.
  
  
  METHODS
  tertiary falls and neuro-otology clinics and local community centres, London, UK.
  
  
  METHODS
  community-dwelling older adults experiencing: (i) ≥2 unexplained falls within the previous 12-months (Group F, n = 25), (ii) a confirmed peripheral vestibular disorder (Group PV, n = 15) and (iii) healthy non-fallers (Group H, n = 16). All the participants completed quantitative vestibular function tests, the functional gait assessment (FGA), physiological profile assessment (PPA) and subjective measures for common vestibular symptoms (i.e. giddiness), balance confidence during daily activities and psychological state.
  
  
  RESULTS
  a clinically significant vestibular impairment was noted for 80% (20/25) of Group F compared with 18.75% (3/16) for Group H (P < 0.01). Group F performed less well in complex gait tasks (FGA), and reported a greater number of falls than both Groups H and PV (P < 0.05). Vestibular symptom scores showed no significant difference between Groups F and PV.
  
  
  CONCLUSIONS
  vestibular dysfunction is significantly more prevalent in older adult fallers versus non-fallers. Individuals referred to a falls clinic are older, more impaired and report more falls than those referred to a neuro-otology department. A greater awareness of vestibular impairments may lead to more effective management and treatment for older adult fallers.
authors.affiliation: Centre of Human and Aerospace Physiological Sciences, King's College London, London, UK.
authors.forename: Matthew Bryan
authors.initials: MB
authors.lastname: Liston
authors.forename: Doris-Eva
authors.initials: DE
authors.lastname: Bamiou
authors.forename: Finbarr
authors.initials: F
authors.lastname: Martin
authors.forename: Adrian
authors.initials: A
authors.lastname: Hopper
authors.forename: Nehzat
authors.initials: N
authors.lastname: Koohi
authors.forename: Linda
authors.initials: L
authors.lastname: Luxon
authors.forename: Marousa
authors.initials: M
authors.lastname: Pavlou
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D016022:Case-Control Studies; D005260:Female; D005684:Gait; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D008603:Mental Health; D009460:Neurologic Examination; D010865:Pilot Projects; D004856:Postural Balance; D015995:Prevalence; D012017:Referral and Consultation; D012307:Risk Factors; D013038:Specialization; D011795:Surveys and Questionnaires; D013997:Time Factors; D015837:Vestibular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D014722:Vestibule, Labyrinth / Q000503:physiopathology*
keywords: balance; falls; older people; vestibular