Benign paroxysmal positional vertigo and vestibular impairment among older adults with dizziness

Ellen Lindell; Therese Karlsson; Lena Kollén; Mia Johansson; Caterina Finizia

doi:10.1002/lio2.566

Benign paroxysmal positional vertigo and vestibular impairment among older adults with dizziness

Laryngoscope Investig Otolaryngol. 2021 May 6;6(3):488-495. doi: 10.1002/lio2.566. eCollection 2021 Jun.

Authors

Ellen Lindell^{1

2}, Therese Karlsson^{1

3}, Lena Kollén^{3

4}, Mia Johansson^{5

6}, Caterina Finizia^{1

3}

Affiliations

¹ Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden.
² Department of Otorhinolaryngology, Region Västra Götaland Södra Älvsborg Hospital Sweden.
³ Department of Otorhinolaryngology, Head and Neck Surgery, Region Västra Götaland Sahlgrenska University Hospital Gothenburg Sweden.
⁴ Department of Occupational Therapy and Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden.
⁵ Department of Oncology, Region Västra Götaland Sahlgrenska University Hospital/Sahlgrenska Gothenburg Sweden.
⁶ Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden.

Abstract

Objective: This article aimed to investigate older adults visiting a geriatric institution for a bone density measurement who reported dizziness on a daily or weekly basis (but who are not seeking care for dizziness), according to BPPV, vestibular function, walking abilities, and frequency of falls.

Methods: Patients coming for a bone density measurement answered questions regarding occurrence of dizziness. Patients having dizziness on a daily or weekly basis were considered eligible for the study and invited for investigation at the Ear, Nose, and Throat clinic at Södra Älvsborg Hospital, Sweden. The patients answered questions about history of dizziness, medications, and comorbidities. They were also investigated for BPPV, vestibular deficits using the video head impulse test (vHIT), walking speed, Timed Up and Go test (TUG), and for perception of verticality and horizontality and Romberg test.

Results: A total of 55 patients with dizziness were included. Fifteen (27%) were diagnosed with BPPV. Forty (73%) patients reported falling during the previous year, including 11 with BPPV. Dizziness when turning in bed was more common among patients with BPPV and increased the risk of BPPV 8-fold.

Conclusion: BPPV is common among older adults with dizziness, including among those not seeking medical care. It is important to identify older adults with BPPV and treat the condition since BPPV may contribute to falls. Asking about dizziness when turning in bed can help to distinguish patients with increased risk for BPPV and older adults with dizziness should be investigated for BPPV even when typical history is lacking. Level of evidence: 4.

Keywords: BPPV; aged; dizziness; vestibular function; walking.