DISEQUILIBRIUM OF UNKNOWN CAUSE IN OLDER-PEOPLE
DISEQUILIBRIUM OF UNKNOWN CAUSE IN OLDER-PEOPLE
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DOI：
10.1002/ana.410340512
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发表时间：
1993-11-01
影响因子：
11.2
通讯作者：
BALOH, RW
中科院分区：
文献类型：
--
作者：
FIFE, TD;BALOH, RW
许多老年人抱怨站立或行走时有不稳定感，许多人害怕摔倒。这种不平衡的原因往往难以确定，即使经过全面的临床评估。为了更好地了解这种症状在社区居民中的发病机制，我们研究了26名年龄>75岁的患者，他们主诉不平衡，临床评估后没有明显的原因。每例患者和26名年龄匹配的对照者都进行了全面的评估，包括病史和检查、问卷调查、功能量表、步态和平衡量表、简易精神状态测试、听力测定、视力、视觉跟踪、旋转前庭测试和定量姿势描记术。虽然没有人有龙伯格的迹象，患者往往摇摆更多，做半定量步态和平衡测试比对照组差。在大多数其他测量中，患者与对照组几乎没有差异。然而，7名患者，指定为V组，前庭功能严重下降。其余19例患者（D组）的平均前庭功能仍明显低于对照组。与对照组相比，用姿势描记法测量的患者摇摆速度增加，特别是在V组患者中。前庭功能的措施与增加摇摆速度在D组单独和所有研究参与者。前庭功能的定量测量应考虑在老年人抱怨不平衡，特别是如果原因是不明显的初步评估后。
Many older people complain of a sense of unsteadiness when standing or walking and many are fearful of falling. The cause of this disequilibrium is often difficult to determine even after thorough clinical evaluation. To better understand the pathogenesis of this symptom in a community-dwelling population, we studied 26 patients >75 years old who complained of disequilibrium in whom no cause was evident after clinical evaluation. Each patient and each of 26 age-matched controls underwent a comprehensive evaluation that included a history and examination, a questionnaire, functional scales, a gait and balance scale, mini-mental state testing, audiometry, visual acuity, visual tracking, rotational vestibular testing, and quantitative posturography. Although none had Romberg's sign, patients tended to sway more and do poorer on semiquantitative gait and balance testing than did controls. Patients showed few differences from controls for most other measurements. However, 7 patients, designated Group V, had profoundly reduced vestibular function. In the remaining 19 patients (Group D), the average vestibular function was still significantly lower than controls. Sway velocity measured with posturography was increased in the patients compared with controls, particularly in Group V patients. Measures of vestibular function correlated with increased sway velocity both in Group D alone and among all study participants. Quantitative measurement of vestibular function should be considered in older people complaining of disequilibrium, particularly if the cause is not apparent after the initial evaluation.