ORIGINAL ARTICLES   

Otorinolaringologia 2006 June;56(2):81-5

Copyright © 2006 EDIZIONI MINERVA MEDICA

language: English

Electronystagmographic alterations in older people

Dellepiane M. ¹, Medicina M. C. ¹, Mura A. C. ², Mora R. ¹, Jankowska B. ¹

¹ ENT Department, University of Genova, Genoa, Italy 2 ENT Department, Galliera Hospital, Genoa, Italy

Aim. Dizziness, dysequilibrium, and falls are common among older people and increase in frequency with age. It is believed that aging alone may contribute to a reduced efficiency of the vestibular system through a slowly progressive vestibulopathy that is enhanced by reduced adaptive plastic mechanisms and by associated dysfunction of vision, proprioception, and muscular output. At the present, however, there are not exact clinicopathological correlations to support this concept. In this study we investigated electronystagmographic (ENG) changes related to aging both of the vestibulo-ocular reflex (VOR) with stop test and of optokinetic nystagmus (OKN) with stare test, to understand if there is a common pattern with increasing age.
Methods. Older group: 34 subjects (14 men and 20 women, ages 50 to 79 years, mean 63.2). Control group: 20 healthy subjects (12 men and 8 women, ages 24 to 27 years, mean 25.2). Subjects were restrained in an electrically drum chair and both VOR by stop-test and OKN stare type were recorded. Data were digitalized for computerized analysis.
Results. In the older group VOR gain was reduced (P<0.05); OKN gain did not significantly differ from the control, but with the age showed a significant asymmetry expressed as the difference between the left and right side for each patient.
Conclusion. Our study showed that, despite the plasticity of the vestibular system plays a role in maintaining an efficient apparatus, the vestibular system in the elderly may be considered to be in a less stable equilibrium.Some alterations may be also considered characteristic of aging, particularly the observed progressive and slow deterioration of the VOR, compatible with a progressive vestibulopathy and also the noticeable OKN asymmetry, which suggests that the alterations in the central pathways may have a relevant role in vestibular disorders of older people.