Presbyvestibulopathy, Comorbidities, and Perception of Disability: A Cross-Sectional Study

Abstract

Objective: To assess the perception of disability in patients with presbyvestibulopathy and to determine the factors (demographic, balance test scores, and comorbidities) that determine higher levels of disability. Material and Methods: This was a cross-sectional study conducted in a tertiary university hospital. There were 103 patients who fulfilled the diagnostic criteria for presbyvestibulopathy and were included. Dizziness Handicap Inventory (DHI) score was the main variable used to quantify disability. Influence on DHI score, sex, age, time of evolution, equilibriometric parameters (posturographic scores and timed up and go test), history of falls, comorbidities (high blood pressure, diabetes, and dyslipidemia), psychotropic drug use, tobacco or alcohol use, living environment (urban or rural), and active lifestyle were analyzed. Results: Most of the DHI scores showed a moderate (46 patients, 44.7%) or severe (39 participants, 37.9%) handicap. DHI scores were higher in women (59.8 vs. 36.1, p < 0.001), patients with obesity (58.92 vs. 48.68; p = 0.019), benzodiazepine (59.9 vs. 49.1, p = 0.008) or other psychotropic drug (60.7 vs. 49.2, p = 0.017) users, and fallers (57.1 vs. 47.3, p = 0.048). There was also a significant positive correlation between DHI score, time (Rho coefficient: 0.371, p < 0.001), and steps (Rho coefficient: 0.284, p = 0.004) used in the TUG and with the short FES-I questionnaire (a shortened version of the Falls Efficacy Scale-International) score (Rho coefficient: 0.695, p < 0.001). DHI scores were lower in alcohol consumers than in non-drinkers (46.6 vs. 56, p = 0.048). No significant correlation was found between DHI scores and age, time of evolution, posturographic scores, comorbidities, environment (rural or urban), or active lifestyle. Conclusion: Most patients with presbyvestibulopathy show an important subjective perception of disability in relation to their symptoms. This perception is substantially higher in women than in men. The most influential factors are difficulties in walking, fear of falling, and obesity. Unique Identifier: NCT03034655, www.clinicaltrials.gov .

Chronic vestibular syndromes in the elderly: Presbyvestibulopathy—an isolated clinical entity?

“…Compared to the study by Soto-Varela and colleagues, the mean DHI values in our PVP cohort were lower, thus reflecting only moderate impairment (40.6 vs. 53.65) [18]. As expected by the lesser peripheral vestibular dysfunction, patients with PVP showed significantly lower clinical impairment measured by physical DHI than patients with BVP in the matched-paired analyses (Figure 3).…”

“…The study by Soto‐Varela and colleagues focused on patients´ self‐perception of disability and the identification of variables influencing DHI in a geriatric cohort. [18,19]. The data are not comparable to our unselected cohort including all patients aged ≥60 years with chronic dizziness, because of their different approach, selecting highly impaired elderly patients and not applying specific neuro‐otological assessment or breakdown of comorbidities in functionally relevant systems [18].…”

“…[18,19]. The data are not comparable to our unselected cohort including all patients aged ≥60 years with chronic dizziness, because of their different approach, selecting highly impaired elderly patients and not applying specific neuro‐otological assessment or breakdown of comorbidities in functionally relevant systems [18].…”

“…However, data about the frequency of gait-relevant comorbidities in PVP patients are still lacking. A previous study on PVP, conducted by Soto-Varela and colleagues, concentrated on various epidemiologic and lifestyle parameters in a geriatric patient sample; it lacks specific neuro-otological examination [18,19].…”

Incidence and clinical characteristics of fall-related injuries among older inpatients at a tertiary grade a hospital in Shandong province from 2018 to 2020

“…All statistical tests were two-sided, and the significance level was set at P < 0.05. Based on the number of falls in the previous 3 months, patients were divided into recurrent fallers (at least one fall in the hospital or in the community) and single-fallers (no falls) [ 20 ] to analyze the statistical differences in the incidence of recurrent falls among the groups with different characteristics. We also analyzed the differences in the incidence of injurious falls among the different characteristic groups.…”