Aging of the Human Vestibular System
Aging of the Human Vestibular System
复制标题
DOI：
10.1055/s-0035-1555120
复制
发表时间：
2015-08-01
影响因子：
--
通讯作者：
Zalewski, Christopher K.
中科院分区：
文献类型：
--
作者：
Zalewski, Christopher K.
衰老影响身体的每一个感觉系统，包括前庭系统。尽管其影响往往难以量化，但衰老对前庭系统的有害影响在医学和经济上都是严重的。自20世纪70年代以来，人们已经知道前庭感觉末端器官的退化；然而，这些解剖变化的可测量影响仍然难以捉摸。前庭功能测试要么无法量化这种解剖退化，要么对伴随前庭衰老过程的相关生理衰退和/或中枢代偿机制不敏感。与健康的年轻人相比，健康的老年人在测试结果中几乎没有细微的差异，而且这些差异通常只在对非传统和/或更强的刺激的反应中观察到。此外，报告的差异通常在临床上不显著，因此记录的老年人生理反应通常落在正常健康成人的广泛规范反应范围内。这种前庭感觉衰退的破坏性经济影响表现为老年人头晕的指数增长和随后的伤害性跌倒的更高患病率。据报道，与跌倒相关的伤害每年造成的损失估计为100亿至200亿美元，是老年人死亡的第六大原因，死亡率为20%。据估计，到2050年，65岁以上的老年人口将增加115%，伴有前庭系统衰退的平衡障碍患者的数量肯定会达到接近流行病的比例。了解年龄对前庭系统的影响是必要的，如果临床医生要更好地管理老年患者的平衡障碍，头晕，和前庭疾病。
Aging affects every sensory system in the body, including the vestibular system. Although its impact is often difficult to quantify, the deleterious impact of aging on the vestibular system is serious both medically and economically. The deterioration of the vestibular sensory end organs has been known since the 1970s; however, the measurable impact from these anatomical changes remains elusive. Tests of vestibular function either fall short in their ability to quantify such anatomical deterioration, or they are insensitive to the associated physiologic decline and/or central compensatory mechanisms that accompany the vestibular aging process. When compared with healthy younger individuals, a paucity of subtle differences in test results has been reported in the healthy older population, and those differences are often observed only in response to nontraditional and/or more robust stimuli. In addition, the reported differences are often clinically insignificant insomuch that the recorded physiologic responses from the elderly often fall within the wide normative response ranges identified for normal healthy adults. The damaging economic impact of such vestibular sensory decline manifests itself in an exponential increase in geriatric dizziness and a subsequent higher prevalence of injurious falls. An estimated $10 to $20 billion dollar annual cost has been reported to be associated with falls-related injuries and is the sixth leading cause of death in the elderly population, with a 20% mortality rate. With an estimated 115% increase in the geriatric population over 65 years of age by the year 2050, the number of balanced-disordered patients with a declining vestibular system is certain to reach near epidemic proportions. An understanding of the effects of age on the vestibular system is imperative if clinicians are to better manage elderly patients with balance disorders, dizziness, and vestibular disease.