Hypovitaminosis D, Low Bone Mineral Density, and Diabetes Mellitus as Probable Risk Factors for Benign Paroxysmal Positional Vertigo in the Elderly

Abstract

Introduction Studies have found that elderly patients with benign paroxysmal positional vertigo (BPPV) may present low levels of vitamin D (25 (OH) D), changes in bone mineral density, and diabetes mellitus (DM). Objective: To investigate the possible association between BPPV, bone mineral density, hypovitaminosis D, 25 (OH) D and DM. Methods The sample consisted of 109 elderly subjects. The BPPV was verified by a standardized questionnaire and the Dix-Hallpike maneuver. Blood samples were collected for the investigation of 25 (OH) D serum levels. The bone mineral density was evaluated by means of a densitometer. Diabetes mellitus verification was performed using a self-reported questionnaire. Results Of the 109 participants, 17 had BPPV. There was a statistically significant difference between BPPV and gender (p = 0.027, phi = 0.222), with female representing 88.2% of those with BPPV. In the group with BPPV, there was a statistically significant difference for the amount of vitamin D found (p = 0.001) and for age (p = 0.001). In the elderly group with DM and BPPV, a difference was found for the standard deviation of the femur (p = 0.022) with posthoc Dunn, identifying the difference between diabetics with and without BPPV (p = 0.047). Conclusion Although no association was found (25 (OH) D levels) with BPPV in the general population of this study, it was observed that there was an association with bone mineral density in the elderly group with DM and BPPV, and, in the group with BPPV, there was an association between the amount of vitamin D and age.

Effects of Neurological Disorders on Bone Health

“…BPPV is a vestibular dysfunction that is typically unilateral and characterized by short, intense episodes of vertigo. BPPV represents 20-30% of dizziness diagnoses, with no current consensus on its etiology and pathogenesis (Grill et al, 2014;Bazoni et al, 2020). However, the incidence of BPPV increases with age and is believed to involve abnormal stimulation of the cupula by otoliths in any of the three semicircular canals upon changes in head position (Furman and Cass, 1999).…”

Diabetes Mellitus and Hearing Loss: A Complex Relationship

“…There is growing attention paid to the relationship between diabetes and inner ear structures. [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 ] In particular, there is a wealth of evidence suggesting that hearing loss (HL) may be a disabling complication of diabetes mellitus (DM) [ 26 , 27 ]. The consequences of DM affecting the ear can include the ability to understand speech, the risk of falling, and the onset of tinnitus, with concerns ranging from a lowered quality of life to an increase in mortality.…”