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. 2015 Sep;63(9):1837-44.
doi: 10.1111/jgs.13609. Epub 2015 Aug 27.

Association Between Visuospatial Ability and Vestibular Function in the Baltimore Longitudinal Study of Aging

Robin T Bigelow  1 , Yevgeniy R Semenov  1 , Carolina Trevino  1 , Luigi Ferrucci  2 , Susan M Resnick  3 , Eleanor M Simonsick  4 , Qian-Li Xue  5   6 , Yuri Agrawal  1
Affiliations

Association Between Visuospatial Ability and Vestibular Function in the Baltimore Longitudinal Study of Aging

Robin T Bigelow et al. J Am Geriatr Soc. 2015 Sep.

Abstract

Objectives: To investigate the relationship between vestibular loss associated with aging and age-related decline in visuospatial function.

Design: Cross-sectional analysis within a prospective cohort study.

Setting: Baltimore Longitudinal Study of Aging (BLSA).

Participants: Community-dwelling BLSA participants with a mean age of 72 (range 26-91) (N = 183).

Measurements: Vestibular function was measured using vestibular-evoked myogenic potentials. Visuospatial cognitive tests included Card Rotations, Purdue Pegboard, Benton Visual Retention Test, and Trail-Making Test Parts A and B. Tests of executive function, memory, and attention were also considered.

Results: Participants underwent vestibular and cognitive function testing. In multiple linear regression analyses, poorer vestibular function was associated with poorer performance on Card Rotations (P = .001), Purdue Pegboard (P = .005), Benton Visual Retention Test (P = 0.008), and Trail-Making Test Part B (P = .04). Performance on tests of executive function and verbal memory were not significantly associated with vestibular function. Exploratory factor analyses in a subgroup of participants who underwent all cognitive tests identified three latent cognitive abilities: visuospatial ability, verbal memory, and working memory and attention. Vestibular loss was significantly associated with lower visuospatial and working memory and attention factor scores.

Conclusion: Significant consistent associations between vestibular function and tests of visuospatial ability were observed in a sample of community-dwelling adults. Impairment in visuospatial skills is often one of the first signs of dementia and Alzheimer's disease. Further longitudinal studies are needed to evaluate whether the relationship between vestibular function and visuospatial ability is causal.

Keywords: aging; cognition; vestibular function; visuospatial ability.

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Conflict of interest statement

Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this paper.

Figures

Figure 1
Figure 1
Structural equation models of vestibular function as a partial mediator of the association between age and visuospatial cognitive tests. All models were adjusted for demographic, cardiovascular, and sensory risk factors, as in the Model 2 regressions. Percentage mediation is calculated based on the formula: (A*B)/(A*B)+C, where A*B is the indirect effect of age on cognitive function mediated by vestibular function, C is the direct effect of age on cognitive function, and (A*B)+C is the total effect of age on cognitive function. (A) Structural equation model of association between age, vestibular function and the Card Rotation test (n = 136). Vestibular function mediates 11% of the association between age and Card Rotation test score. (B) Structural equation model of association between age, vestibular function, and the Trail-Making Test (TMT) Part B (n = 104). Vestibular function mediates 11% of the association between age and TMT B time. (C) Structural equation model of association between age, vestibular function, and the Benton Visual Retention Test (BVRT) (n = 133). Vestibular function mediated 12% of the association between age and BVRT performance. (D) Structural equation model of association between age, vestibular function, and the Purdue Pegboard test (n = 117). Vestibular function mediates 5% of the association between age and Purdue Pegboard test score.
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