Aging Vestibular System Flashcards
what fraction of people over 65 fall every year
- 1/3
- but only 10% of those falls result in injury
- but women are twice as likely as men to get injured because of osteoporosis
contributing factors of falling (4)
- gait an balance impairments
- lower extremity weakness
- visual impairments
- dizziness and vertigo
vestibular pathology in the aging patient
- for the pt who is struggling with peripheral vestibular pathology, the struggle becomes even greater when they cannot rely on their other senses to help out when the vestibular system is faulty
- little is known regarding the interaction of vestibular loss and aging
postural stability
the ability to maintain the center of mass of the body positioned over the small base of support provided by the feet
—remember vestibular, proprioceptive, and visual systems all work together
loss of sensory hair cells with aging
- hair cells degenerate with age in the semicircular canals and the otolith organs
- –there is a 20-40% decrease in hair cells between the ages of 40-75
aging visual system
- changes may include reduced:
- –acuity
- –depth perception
- –contrast sensitivity
- –adaptation
- –ability to detect motion in the visual field
three factors that can play a role in the function of the visual system
- caratacts
- glaucoma
- macular degeneration
- –this can interfere with testing if they cant see
the aging somatosensory system
- when testing the importance of the somatosensory system, research was conducted with the foot of the subject being anaesthetized
- –there was a significant decrease in postural control when the foot was anaesthetized
- –this can be similar to the effect of neuropathy
aging neuromuscular system
- strength of lower extremities is very important
- reduced ankle strength makes id difficult too recover from even small changes in posture
- –slight bump that would have us use ankle strategies may require a step strategy for an elderly pt
- –if this reflex is delayed a fall is more likely to occur
- –pt will step, reach, and grab to help prevent falling
- —-this may mean you are going down too
- – a desperate person will make desperate moves
age and attention
*when given a task or other activity to focus on postural sway will increase even in the young and healthy population but really causes problems for an aging and impaired pt
goals of rehabilitation
- reduce symptoms
- improve gaze stability
- improve postural stability
- return to normal activities
- –work, driving, physical activity
a good rehab program will include
- exercises to habituate symptoms
- –repeated exposure to symptom inducing activity
- exercises to promote gaze stabilization
- –via adaptation and substitution allowing for improvement in gaze stability
- exercises to improve balance and gait
- –focusing on strengthening the somatosensory abilities to help out the damages vestibular system
psychological impact of aging and the fear of falling
- with an increased fear of falling comes a pt response to limit their activities, which can lead to depression, anxiety, and embarrassment
- changes in gait (shuffling of feet, stiff motion may be reflective of the fear of falling
