Caloric response does not decline with age

Complaints of imbalance in the elderly are commonly heard by clinicians, and pathology of the vestibular system may play an important role in these complaints. While there is solid anatomical evidence for age related decline of some vestibular structures, a corresponding deterioration in physiologic function has not been convincingly demonstrated. Vestibular function is traditionally measured with caloric irrigations. Although there has been some age dependent change in caloric response shown, there is no good parallel between caloric response and imbalance in the elderly patient. Our experiment confirms that slow phase velocity of caloric responses does not decline with age. Calorics measure only one part of the vestibular system, and so should not be regarded as representative of balance system function. As a result, measured caloric response does not parallel documented anatomic age-related decline of the vestibular system.