Association Between Vestibular and Cognitive Function in U.S. Adults: Data From the National Health and Nutrition Examination Survey

Semenov, Yevgeniy R.; Bigelow, Robin T.; Qin, Xue; du, Sascha; Agrawal, Yuri

doi:10.1093/gerona/glv069

Cited by 112 publications

(95 citation statements)

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“…10 Although hearing loss has not been established as a causal factor for falls, earlier studies report an association between hearing impairment and risk of falls. Possible explanations for the association between hearing loss and falls include coexistent vestibular pathology that increases fall risk, 11 reduction in cognitive capacity for balance given the cognitive load of hearing loss, [12][13][14][15] and a loss of auditory perception leading to reduced spatial awareness. 16 Hearing loss is itself a highly prevalent condition among older adults that can be readily treated with amplification.…”

Section: Introductionmentioning

confidence: 99%

Hearing loss and falls: A systematic review and meta‐analysis

2016

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Section: Introductionmentioning

confidence: 99%

Hearing loss and falls: A systematic review and meta‐analysis

2016

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“…2,3 Video recordings of consenting patients before and after intervention help to further document these obvious alterations in ways that complement standardized neuropsychology testing. [5][6][7][8][9][10][11][12][13][14][15][16][17][18] Other investigators have also explored the relationship between vestibular dysfunction and cognitive dysfunction; [19][20][21][22][23][24][25][26][27][28] however, Gizzi and coworkers used the Neurobehavioral Symptom Inventory, and the Beck Depression Inventory and reported no causal connection between vestibular disorders and cognitive dysfunction. 28 They studied 200 patients with "dizziness""-half with a history of brain trauma and half without.…”

Section: Introductionmentioning

confidence: 99%

Comorbidities confounding the outcomes of surgery for third window syndrome: Outlier analysis

Wackym

Mackay-Promitas

Demirel

et al. 2017

Laryngoscope Investig Oto

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ObjectivePatients with third window syndrome and superior semicircular canal dehiscence (SSCD) symptoms whose surgical outcomes placed them as outliers were systematically studied to determine comorbidities that were responsible for their poor outcomes due to these confounding factors.Study DesignObservational analytic case‐control study in a tertiary referral center.MethodsTwelve adult patients with clinical SSCD syndrome underwent surgical management and had outcomes that did not resolve all of their subjective symptoms. In addition to one of the neurotologists, 2 neurologists (one specializing in migraine and the other a neuro‐ophthalmologist), and a psychologist clinician‐investigator completed comprehensive evaluations. Neuropsychology test batteries included: the Millon Behavioral Medicine Diagnostic; Patient Health Questionnaire (PHQ‐9) and Generalized Anxiety Disorder Screener (GAD‐7); Adverse Childhood Experiences Scale; the Wide Range Assessment of Memory and Learning, including the 3 domains of verbal memory, visual memory, and attention/concentration; Wechsler Adult Intelligence Scale; and the Delis‐Kaplan Executive Function System. The control cohort was comprised of 17 participants who previously underwent surgery for third window syndrome that resulted in the expected outcomes of resolution of their third window syndrome symptoms and cognitive dysfunction.ResultsThere was a high rate of psychological comorbidity (n = 6) in the outlier cohort; multiple traumatic brain injuries were also a confounding element (n = 10). One patient had elevated cerebrospinal fluid (CSF) pressure requiring ventriculoperitoneal shunting to control the recurrence of dehiscence and one patient with a drug‐induced Parkinson‐like syndrome and idiopathic progressive neurological degenerative process.ConclusionsComponents of the Millon Behavioral Medicine Diagnostic, PHQ‐9 and GAD‐7 results suggest that these instruments would be useful as screening tools preoperatively to identify psychological comorbidities that could confound outcomes. The identification of these comorbid psychological as well as other neurological degenerative disease processes led to alternate clinical management pathways for these patients.Level of Evidence2b.

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“…It is thought to provide important computations for map-70 based or allocentric navigation [16,17]; computations specific to the orientation strategy.71 Vestibular dysfunction, the partial or complete loss of function in the vestibular organ or central 72 pathways, is a less well known, but widespread neurological disorder. In an ongoing cross-73 sectional survey in the United States, vestibular dysfunction, measured by the presence of 5 74 vertigo/dizziness, was present in over half of the individuals over the age of 40 [18]. Vestibular 75 dysfunction also leads to a decrease in hippocampal size and an associated decrease in 76 navigational ability [3,19,20].…”

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Who gets lost and why: A representative cross-sectional survey on sociodemographic and vestibular determinants of wayfinding strategies

Ulrich

Grill

Flanagin

2018

Preprint

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2 When we think of our family and friends, we probably know someone who is good at finding 3 their way and someone else that easily get lost. We still know little about the biological and 4 environmental factors that influence our navigational ability. Here, we investigated the 5 frequency and sociodemographic determinants of wayfinding and their association with 6 vestibular function in a representative cross-sectional sample (N = 783) of the adult German-7 speaking population. Wayfinding was assessed using the Wayfinding Strategy Scale, a self-8 report scale that produces two scores for each participant representing to what degree they rely 9 on route-based or orientation (map-based) strategies. We were interested in the following 10 research questions: (1) the frequency and determinants of wayfinding strategies in a population-11 based representative sample, (2) the relationship between vestibular function and strategy 12 choice and (3) how sociodemographic factors influence general wayfinding ability as measured 13 using a combined score from both strategy scores. Our linear regression models showed that 14 being male, having a higher education, higher age and lower regional urbanization increased 15 orientation strategy scores. Vertigo/dizziness reduced the scores of both the orientation and the 16 route strategies. Using a novel approach, we grouped participants by their combined strategy 17 scores in a multinomial regression model, to see whether individuals prefer one strategy over 18 the other. The majority of individuals reported using either both or no strategy, instead of 19 preferring one strategy over the other. Young age and reduced vestibular function were 20 indicative of using no strategy. In summary, wayfinding ability depends on both biological and 21 environmental factors; all sociodemographic factors except income. Over a third of the 22 population, predominantly under the age of 35, does not successfully use either strategy. This 23 represents a change in our wayfinding skills, which may result from the technological advances 24 in navigational aids over the last few decades. 25 3 26 Introduction 27 Wayfinding; the ability to find one's way in an unfamiliar environment, has an outstanding 28 place among our cultural skills. The ability to find one's way in a complex environment is no 29 trivial feat. It is therefore not surprising that we find a high degree of variability in individuals' 30 ability and the strategies used and declines in normal aging [1], in neurodegenerative disease 31 [2] and with vestibular dysfunction [3,4]. These strategies have been broadly defined as route 32 strategies and orientation strategies [5,6]. The difference between these two strategies is 33 demonstrated in Figure 1. 34 35 Figure 1. Illustration of the two main wayfinding strategy types. Left: the orientation strategy, in 36 which individuals use spatial relations and global reference points such as the sun or cardinal directions to 37 navigate. Individuals that use this strategy often report having a 2D m...

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Association Between Vestibular and Cognitive Function in U.S. Adults: Data From the National Health and Nutrition Examination Survey

Abstract: This study suggests that vestibular dysfunction partially mediates the association between age and cognitive impairment. Moreover, the cognitive impairment that results from vestibular loss may contribute to ADL difficulty and falls in older individuals.

Cited by 112 publications

References 39 publications

Hearing loss and falls: A systematic review and meta‐analysis

Hearing loss and falls: A systematic review and meta‐analysis

Comorbidities confounding the outcomes of surgery for third window syndrome: Outlier analysis

Who gets lost and why: A representative cross-sectional survey on sociodemographic and vestibular determinants of wayfinding strategies

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