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Assessment of vestibular function in elderly patients

Krager, Rachael

Current Opinion in Otolaryngology & Head and Neck Surgery: October 2018 - Volume 26 - Issue 5 - p 302–306
doi: 10.1097/MOO.0000000000000476

Purpose of review Individuals over the age of 60 are at an increased risk of falls, even if they do not have an isolated dysfunction of the vestibular system. The aim of this article is to review the various vestibular testing currently available and its usefulness in determining the presence of vestibular dysfunction in the elderly population. The primary vestibular tests to be reviewed include: balance function testing, vestibular evoked myogenic potentials (VEMPs), and video head impulse testing (vHIT).

Recent findings Balance function testing is important as it evaluates the integration of vestibular information along with sensory and visual information, which may also be impaired. VEMP testing provides a small diagnostic yield as most elderly patients have absent or reduced responses. vHIT gain is reduced in this population, but will still be within the normal range for individuals with normal balance function.

Summary The combination of various vestibular tests provides complimentary information instead of redundant information on the patient's balance function. Each test evaluates various aspects of the vestibular system which are all needed to determine stable balance in the elderly population.

Department of ENT-Audiology, UC Davis Medical Center, Sacramento, California, USA

Correspondence to Rachael Krager, Audiologist, UC Davis Medical Center, 2521 Stockton Blvd., 6th Floor, Sacramento, CA 95817, USA. E-mail:

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