Prevalence and impact of bilateral vestibular hypofunction: results from the 2008 US National Health Interview Survey

JAMA Otolaryngol Head Neck Surg. 2013 Aug 1;139(8):803-10. doi: 10.1001/jamaoto.2013.3913.


Importance: Profound bilateral vestibular hypofunction (BVH) causes disabling oscillopsia, chronic disequilibrium, and postural instability, but little is known about its epidemiology and impact.

Objective: To assess prevalence and functional impact of BVH in the US adult population.

Design and setting: National cross-sectional survey using a national database and corollary validation study.

Patients: Adult respondents to the 2008 Balance and Dizziness Supplement to the US National Health Interview Survey (N = 21 782).

Main outcomes and measures: Prevalence of BVH, socioeconomic and quality-of-life impact of BVH, and fall risk. Criteria for the survey-based diagnosis of BVH included all of the following: presence of visual blurring with head movement; unsteadiness; difficulty walking in darkness or unsteady surfaces and in a straight path; and symptoms being at least "a big problem" and present for at least 1 year, in the absence of other neurologic conditions or eye pathologic conditions affecting vision.

Results: Adjusted national estimates from this survey indicate the prevalence of BVH in 2008 was 28 per 100 000 US adults (64 046 Americans). Of the participants with BVH, 44% reported changing their driving habits because of their symptoms, 56% reported reduced participation in social activities, and 58% reported difficulties with activities of daily living. Respondents with BVH had a 31-fold increase in the odds of falling in multivariate analyses compared with all respondents, with 25% reporting a recent fall-related injury.

Conclusions and relevance: As estimated by the presence of specific symptoms in a nationally representative survey, BVH has considerable socioeconomic and quality-of-life impacts and significantly increases fall risk. These data support the need for new therapeutic strategies for BVH, including vestibular rehabilitation and implantable vestibular prostheses.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Activities of Daily Living
  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Cross-Sectional Studies
  • Databases, Factual
  • Dizziness / diagnosis
  • Dizziness / epidemiology
  • Dizziness / therapy
  • Female
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Postural Balance*
  • Prevalence
  • Quality of Life
  • Risk Assessment
  • Severity of Illness Index
  • Sex Distribution
  • Sickness Impact Profile*
  • United States / epidemiology
  • Vertigo / diagnosis
  • Vertigo / epidemiology
  • Vertigo / therapy
  • Vestibular Diseases / diagnosis*
  • Vestibular Diseases / epidemiology*
  • Vestibular Diseases / therapy
  • Vision Disorders / diagnosis
  • Vision Disorders / epidemiology*
  • Vision Disorders / therapy
  • Young Adult