Degree of functional impairment associated with vestibular hypofunction among older adults with cognitive decline

Objective:Considering the altered multisensory signal compensation during senescence, the aim of the present study was to evaluate the integration rearrangements in unilateral vestibular hypofunction (UVH) during age-related cognitive decline.Study Design:Cross-sectional study.Setting:Longitudinal cohort study unit and of University tertiary referral center.Patients:Older UVH individuals 55 years with Mild Cognitive Impairment (MCI) or Alzheimer Disease (AD) and matched UVH control group with age-appropriate cognitive function.Intervention:Vestibulo-ocular reflex, postural sway examination (respectively performed by means of video head impulse test and static posturography), and dizziness-related and quality of life scores were collected in all three groups of UVH patients cognitively evaluated by means of Mini Mental State Examination and Alzheimer's Disease Assessment Scale (ADAS-cog).Main Outcome Measures:Vestibulo-ocular reflex gain, length, surface, and spectral values of body oscillation were measured. Dizziness Handicap Inventory, Activities-specific Balance Confidence scale, and Dynamic Gait Index scores were collected.Results:A significant (p<0.05) increase in surface and length values during both eyes closed and eyes open conditions was found when comparing scores for AD to both MCI and control group patients, respectively. These patients demonstrated significantly (p<0.05) lower spectral values of body oscillation on posturography platform in both eyes closed and eyes open condition within the low-frequency interval than MCI and AD patients.Conclusion:This is the first study reporting an association between cognitive decline and posturography parameters with possible preventive clinical implications in evaluating the risk for falls in high-risk patients, such as older adults with common neuro-otological disorders.