Head Impulse Test Abnormalities and Influence on Gait Speed and Falls in Older Individuals
Head Impulse Test Abnormalities and Influence on Gait Speed and Falls in Older Individuals
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DOI：
10.1097/mao.0b013e318295313c
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发表时间：
2013-12-01
影响因子：
2.1
通讯作者：
Carey, John P.
中科院分区：
文献类型：
--
作者：
Agrawal, Yuri;Davalos-Bichara, Marcela;Carey, John P.
目的：评估前庭功能障碍的患病率在老年人使用头部脉冲测试（HIT）和评估的独立影响HIT异常的步态速度和跌倒的风险在老年人研究设计：横断面研究设置：三级保健学术医疗中心患者：50个社区居住的个人年龄在70岁及以上干预措施：击中（异常HIT定义为右侧或左侧HIT异常）、视力、单丝测试和握力。主要结果测量：4米步行时的步态速度和福尔斯史结果：参与者的平均年龄为77岁（范围，70-95岁）; 52%为女性受试者。50%的参与者有异常的HIT。异常HIT与步态速度降低0.23 m/s显著相关（p = 0.042），在过去1年中多了0.44次福尔斯（p = 0.047），并且在过去5年中下降的几率增加了5倍（p = 0.024）在多变量分析中调整了年龄、性别和其他平衡和跌倒风险因素。我们观察到，在我们的研究中，有一半的社区居住的老年人有前庭功能障碍的证据，这是显着相关的步态速度和跌倒风险的调整分析。使用简单的HIT筛查前庭损伤并指导靶向前庭治疗可能对减少老年人的步态损伤和跌倒风险很重要。
Objective: To assess the prevalence of vestibular dysfunction in older adults using the head impulse test (HIT) and to assess the independent influence of HIT abnormalities on gait speed and fall risk in older individuals.Study Design: Cross-sectional study.Setting: Tertiary care academic medical center.Patients: Fifty community-dwelling individuals age 70 and older.Interventions: HIT (abnormal HIT defined as right or left HIT abnormality), visual acuity, monofilament testing, and grip strength.Main Outcome Measures: Gait speed on a 4-meter walk and a history of falls (including number of falls) in the last 1 and 5 years.Results: The participants' mean age was 77 years (range, 70-95 yr); 52% were female subjects. Fifty percent of participants had an abnormal HIT. An abnormal HIT was significantly associated with a 0.23 m/s reduction in gait speed (p = 0.042), 0.44 more falls in the last 1 year (p = 0.047), and a 5-fold increase in the odds of falling in the last 5 years (p = 0.024) in multivariate analyses adjusted for age, sex, and other balance and fall risk factors.Conclusion: We observed that half of the community-dwelling older individuals in our study had evidence of vestibular dysfunction, which was significantly associated with gait speed and fall risk in adjusted analyses. Screening for vestibular impairment using the simple HIT and directing targeted vestibular therapy may be important to reduce gait impairment and fall risk in older individuals.