title: The impaired subjective perception of verticality independent of peripheral vestibular function in dizzy elderly with orthostatic hypotension.
abstract: BACKGROUND
  The elderly often complain of faintness, lightheadedness, dizziness, and unsteadiness, which may be associated with the orthostatic hypotension (OH), but most of them are subclinical. The pathogenic mechanism of subjective symptoms in the elderly with OH is controversial.
  
  
  OBJECTIVE
  The aim of this study was to assess the involvement of the irregularity of the vertical perception in the dizzy elderly with OH.
  
  
  METHODS
  This study consisted of 403 patients seeking treatment for dizziness in our hospital. The neurotological examinations include the subjective visual vertical (SVV) test and the bithermal caloric test. The self-perceived handicapping effects imposed by dizziness were assessed by the dizziness handicap inventory (DHI). The variability (standard deviation) and the average deviation of eight trials (four trials in each direction) were calculated. In addition, they underwent the orthostatic Schellong test for the diagnosis of the OH. They were separated into three groups, including patients aged ≥65 years, patients aged 50-64 years, and patients aged <50 years.
  
  
  RESULTS
  The variability of the SVV in the patients aged ≥65 years with OH was significantly larger than that in the patients aged ≥65 years without OH. There was no significant difference in the average deviation of the SVV, the canal paresis % by the bithermal caloric test, and the DHI score among groups.
  
  
  CONCLUSIONS
  The result suggests that the elderly patients with OH have subclinical impairment in the perception of the verticality independent of the peripheral vestibular function.
authors: Department of Otolaryngology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu City, 501-1194, Japan. aoki@gifu-u.ac.jp.|Department of Medical Information, Gifu University Hospital, 1-1 Yanagido, Gifu City, 501-1194, Japan. aoki@gifu-u.ac.jp.
authors: Mitsuhiro
authors: http://orcid.org/0000-0002-3819-0781
authors: M
authors: Aoki
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004244:Dizziness / Q000209:etiology*; D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D011187:Posture; D018709:Statistics, Nonparametric; D013575:Syncope / Q000209:etiology; D014724:Vestibular Function Tests / Q000706:statistics & numerical data
keywords: Dizziness; Elderly; Orthostatic hypotension; Vertical perception