Decline in Semicircular Canal and Otolith Function With Age

Objective To characterize the physiologic nature of the vestibular dysfunction that occurs with the normative aging process. Study Design Cross-sectional study. Setting Tertiary care academic medical center. Patients Fifty individuals age 70 years and above. Interventions Head thrust dynamic visual acuity testing and cervical and ocular vestibular-evoked myogenic potential (VEMP) testing. Main Outcome Measures Semicircular canal function measured by head thrust dynamic visual acuity testing in each of the 3 semicircular canal planes, and saccular and utricular function measured by cervical VEMP and ocular VEMP testing, respectively. Results We observed significant declines in semicircular canal function in each of the canal planes as well as otolith function associated with aging. We found that individuals with impaired horizontal and superior semicircular canal function also were likely to have concomitant deficits in utricular but not saccular function. Overall, we noted that the prevalence of semicircular canal dysfunction was highest followed by saccular then utricular impairment, although we did observe individuals with isolated otolith deficits. Conclusion These data suggest an overall decline in semicircular canal as well as otolith function associated with aging, although the magnitude of impairment was greater for the semicircular canals than the otoliths in this elderly population. A better understanding of the specific vestibular deficits that occur with aging can inform the development of rational screening, vestibular rehabilitation, and fall risk reduction strategies in older individuals.