Co-Existing Vestibular Hypofunction Impairs Postural Control, but Not Frailty and Well-Being, in Older Adults with Benign Paroxysmal Positional Vertigo

<b>Background:</b> Vestibular hypofunction occurs in 29.5% of older adults with benign paroxysmal positional vertigo (BPPV), but its impact on postural control, well-being and frailty was not studied before. This study compared the well-being, frailty and postural control between older adults with BPPV and vestibular hypofunction (oaBPPV+), and older adults with only BPPV (oaBPPV). <b>Methods:</b> Thirty-one older adults (≥65 years old) diagnosed with BPPV were recruited. Unilateral vestibular hypofunction was defined as a >25% caloric asymmetry, and bilateral vestibular hypofunction as a total response <6°/s per ear, using bithermal caloric irrigations. The oaBPPV+ group was compared to the oaBPPV group using the measures of well-being (Dizziness Handicap Inventory, Falls Efficacy Scale and 15-item Geriatric Depression Scale), frailty (Modified Fried Criteria), and postural control (timed chair stand test, mini-Balance Evaluation Systems test and Clinical Test of Sensory Interaction on Balance (CTSIB)). Falls and the number of repositioning maneuvers were documented. Significance level was set at α = 0.05. <b>Results:</b> Unilateral vestibular hypofunction was present in 32% of participants, mainly in females (<i>p</i> = 0.04). Bilateral vestibular hypofunction was not found. The oaBPPV+ group (<i>n</i> = 10, mean age 72.5 (4.5)) experienced more comorbidities (<i>p</i> = 0.02) than the oaBPPV group (<i>n</i> = 21, mean age 72.6 (4.9)). Groups did not differ regarding dizziness symptoms (<i>p</i> = 0.46), fear of falling (<i>p</i> = 0.44), depression (<i>p</i> = 0.48), falls (<i>p</i> = 0.08) or frailty (<i>p</i> = 0.36). However, the oaBPPV+ group showed significantly worse postural control under vestibular-dependent conditions (<i>p</i> < 0.001). <b>Conclusions:</b> Despite equally impaired well-being and frailty, the oaBPPV+ group showed greater sensory orientation deficits. Clinicians and researchers should be alert for co-existing vestibular hypofunction in older adults with BPPV, since this may exacerbate their already impaired postural control more than only BPPV.