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Vestibular Impairment in Dementia.

Aisha Harun1, Esther S Oh, Robin T Bigelow

  • 1*Department of Otolaryngology-Head and Neck Surgery †Department of Medicine ‡Department of Psychiatry and Behavioral Sciences §Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland ||Longitudinal Studies Section, Translational Gerontology Branch, National Institute of Aging, National Institutes of Health, Baltimore, Maryland.

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|July 29, 2016
PubMed
Summary

Vestibular dysfunction, specifically impaired saccular function, is linked to a higher likelihood of Alzheimer's disease (AD). Reduced vestibular-evoked myogenic potential amplitudes also correlate with decreased AD odds, suggesting a connection between inner ear health and cognitive decline.

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Area of Science:

  • Neuroscience
  • Otolaryngology
  • Geriatrics

Background:

  • Emerging research indicates a relationship between the vestibular system and cognitive functions.
  • Understanding this link is crucial for identifying early markers of cognitive decline.

Purpose of the Study:

  • To investigate vestibular function in individuals with mild cognitive impairment (MCI) and Alzheimer's disease (AD).
  • To compare vestibular function in patients with cognitive impairment against cognitively normal individuals.

Main Methods:

  • A cross-sectional study involving older adults (≥55 years) with MCI or AD and age/sex/education-matched controls.
  • Assessment of saccular and utricular function using cervical and ocular vestibular-evoked myogenic potentials (cVEMPs and oVEMPs).
  • Evaluation of horizontal semicircular canal function via video head impulse testing (VOR gain).

Main Results:

  • Bilaterally absent cVEMPs were associated with a threefold increased odds of AD (OR 3.42).
  • Increased cVEMP and oVEMP amplitudes correlated with decreased odds of AD (OR 0.28 and OR 0.92, respectively).
  • No significant differences in VOR gain were observed between cognitive impairment groups and controls.

Conclusions:

  • Findings support an association between vestibular dysfunction and cognitive impairment, particularly AD.
  • Peripheral vestibular loss may be a contributing factor or an early indicator of cognitive decline.
  • Further research is required to elucidate the causal relationship between vestibular function and cognitive impairment.