Background
Vestibular impairment is an underlying cause in about
45% of elderly dizziness complaining.
Balance results from a complex integration of inputs
at central nervous system level (vestibular, visual and
somesthetic). Disorders of balance in elderly show an
increase in terms of prevalence and severity and can
result from impairment in sensory, motor and central
processing systems for a specific pathology or for physiological
progressive loss of function.
All the balance subsystems [1] are involved, with a
reduction in:
Vestibular receptor cells (20% to 40%) [2]
Visual acuity, field and depth, contrast sensitivity
Myelinated and unmyelinated fibers (axonal atrophy
with decline in conduction velocity and sensory
discrimination)
Speed transmission and processing in brain
Muscle and joint strenght and quality
Vestibular problems are very frequent in elderly starting
from a labirintine ipofunction, we focus on PPV, the
most frequent peripheral vestibular disease, a condition
leading to high risk of fall at this age, to evaluate its real
weight in elderly, from an epidemiological point of view.
Materials and methods
912 PPV patients (mean 55.2yrs) (2005-2008). Complete
otoneurologic evaluation (caloric stimulation, PPV identification
through Dix-Hallpike [3] and Pagnini-McClure
[4] manoeuvres and anamnestic questionnaire for risk
factors.
Results
Females more affected, (1.7/1). Incidence higher
between 5th and 6th decade (57.9%), and decrease
between the 7th and 8th, particularly in females.
This appears to be in contrast with hypothesis that
macular degeneration could enhance the formation of
otolithic clusters in labyrinth.
Conclusion
Frequency, simple diagnosis and high effective treatment
in PPV have led to more widespread use of vestibular
rehabilitation procedures. Because of the high incidence
in 6th decade of life we strongly suggest to take in the
right consideration the risk of fall linked to this
condition