age-associated changes in the vestibular system
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Introduction
The vestibular system undergoes change with aging.
Pathology
- vestibular function generally remains relatively intact into old age
- increased threshold for vestibular response
- age-related degeneration of the organ of Corti gives rise to age-related hearing impairment
- organ of Corti with diminished number of cells
- loss of hair cells in the organ of Corti starts early in life
- loss of hair cells is greatest in persons > 70 years of age.
- outer hair cells are more vulnerable than inner hair cells
- loss of hair cells occurs preferentially in the basal region of the cochlea accounting for the loss of pure-tone hearing
- decline in semicircular canal & otolith function with aging[5]
- prevalence of age-related semicircular canal dysfunction > saccular dysfunction > utricle dysfunction[5]
- association between hearing loss & reduced saccular function with aging[6]
Clinical manifestations
- largely manifests as balance disorder
- dizziness
- vertigo
- vestibulovisual symptoms
- postural symptoms
Diagnostic procedures
- Clinical Test for Sensory Interaction on Balance
- Dix-Hallpike maneuver further documents vestibilar disorder
Management
- vestibular rehabilitation may be of benefit
More general terms
Additional terms
References
- ↑ Essentials of Clinical Geriatrics, 4th ed, Kane RL et al (eds) McGraw Hill, NY, 1999
- ↑ UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 29-Oct 2, 2004
- ↑ The Merck Manual of Geriatrics, 3rdh ed, Merck & Co, Rahway NJ, 2000
- ↑ Taffet GE, Physiology of Aging, In: Geriatric Medicine: An Evidence-Based Approach, 4th ed, Cassel CK et al (eds), Springer-Verlag, New York, 2003
- ↑ 5.0 5.1 5.2 Agrawal Y, Zuniga MG, Davalos-Bichara M et al Decline in semicircular canal and otolith function with age. Otol Neurotol. 2012 Jul;33(5):832-9. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22699991 Free PMC Article
- ↑ 6.0 6.1 Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
- ↑ Agrawal Y, Carey J, eds. Age-related vestibular loss: current understanding and future research directions. Front Neurol. August 2017 https://www.frontiersin.org/research-topics/3709/age-related-vestibular-loss-current-understanding-and-future-research-directions
- ↑ Ji L, Zhai S. Aging and the peripheral vestibular system. J Otol. 2018;13(4):138-140 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30671091 PMCID: PMC6335476 Free PMC article https://www.sciencedirect.com/science/article/pii/S1672293018300965
- ↑ Jahn K. The Aging Vestibular System: Dizziness and Imbalance in the Elderly. Adv Otorhinolaryngol. 2019;82:143-149. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30947233 Review.
- ↑ Ahearn DJ, Umapathy D Vestibular impairment in older people frequently contributes to dizziness as part of a geriatric syndrome. Clin Med (Lond). 2015 Feb;15(1):25-30. . PMID: https://www.ncbi.nlm.nih.gov/pubmed/25650194 PMCID: PMC4954518 Free PMC article