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. 2018 Oct;275(10):2457-2465.
doi: 10.1007/s00405-018-5109-y. Epub 2018 Aug 29.

Gradient Impact of Cognitive Decline in Unilateral Vestibular Hypofunction After Rehabilitation: Preliminary Findings

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Gradient Impact of Cognitive Decline in Unilateral Vestibular Hypofunction After Rehabilitation: Preliminary Findings

Alessandro Micarelli et al. Eur Arch Otorhinolaryngol. .

Abstract

Purpose: Considering recent advances in central cognitive- and age-related processing interfering with balance and sensory reweighting in uncompensated vestibular disorders, purpose of this study is to highlight the vestibular rehabilitation (VR) outcomes in a population of older adults and age-matched mild cognitive impairment (MCI) patients, both affected by unilateral vestibular hypofunction (UVH) and undergoing VR.

Methods: Vestibulo-ocular reflex (VOR), postural sway examination (respectively, performed by video head impulse test and static posturography) and dizziness-related and quality-of-life scores were collected in 12 UVH MCI individuals ≥ 55 years and 12 matched UVH older adults with age-appropriate cognitive function-cognitively evaluated by means of Mini-Mental State Examination (MMSE) and Alzheimer's Disease Assessment Scale-before and after a VR protocol.

Results: A significant post-treatment reduction in surface, length and power spectra (PS) values within low-frequency domain and an improvement in performance measures were recorded in both groups. Moreover, the VR protocol highlighted-when comparing pre-/post-treatment differences (Δ)-a significant (i) increase in Δ VOR gain; (ii) decrease in Δ surface and length and (iii) increase in Δ PS within low-frequency domain in older adults when compared to MCI patients. Positive correlations were found between MMSE and Δ Dynamic Gait Index, Δ surface and Δ PS within low-frequency domain when treating patients as 'a continuum' along the cognitive decline.

Conclusions: Present pilot findings suggest that the cognitive domain insight in older adults scheduled for VR protocols may positively impact on disability consequences.

Keywords: Aging; Cognitive decline; Mild cognitive impairment; Vestibular hypofunction; Vestibular rehabilitation.

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