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. 2015 Jan-Dec:1:2333721415607124.
doi: 10.1177/2333721415607124. Epub 2015 Sep 21.

Vestibular Function and Activities of Daily Living: Analysis of the 1999 to 2004 National Health and Nutrition Examination Surveys

Aisha Harun  1 , Yevgeniy R Semenov  1 , Yuri Agrawal  1
Affiliations

Vestibular Function and Activities of Daily Living: Analysis of the 1999 to 2004 National Health and Nutrition Examination Surveys

Aisha Harun et al. Gerontol Geriatr Med. 2015 Jan-Dec.

Abstract

Objective: Vestibular dysfunction increases with age and is associated with mobility difficulties and fall risk in older individuals. We evaluated whether vestibular function influences the ability to perform activities of daily living (ADLs).

Method: We analyzed the 1999 to 2004 National Health and Nutrition Examination Survey of adults aged older than 40 years (N = 5,017). Vestibular function was assessed with the Modified Romberg test. We evaluated the association between vestibular function and difficulty level in performing specific basic and instrumental ADLs, and total number of ADL impairments.

Results: Vestibular dysfunction was associated with significantly higher odds of difficulty with nine ADLs, most strongly with difficulty managing finances (odds ratio [OR] = 2.64, 95% confidence interval [CI] = [1.18, 5.90]). In addition, vestibular dysfunction was associated with a significantly greater number of ADL impairments (β = .21, 95% CI = [0.09, 0.33]). This effect size was comparable with the influence of heavy smoking (β = .21, 95% CI = [0.06, 0.36]) and hypertension (β = .10, 95% CI = [0.02, 0.18]) on the number of ADL impairments.

Conclusion: Vestibular dysfunction significantly influences ADL difficulty, most strongly with a cognitive rather than mobility-based task. These findings underscore the importance of vestibular inputs for both cognitive and physical daily activities.

Keywords: activities of daily living; disability; function; vestibular loss.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Odds of ADL impairment associated with vestibular dysfunction. Note. ADLs = activities of daily living.
Figure 2.
Figure 2.
Structural equation modeling and mediation analyses. Note. Role of aging and sensory loss in ADL impairment. Vestibular dysfunction mediated 21.7% of the association between aging and ADL impairment. Hearing and vision loss mediated 8.9% and 0%, respectively, of the association between aging and ADL impairment. All models are adjusted for race, gender, education, smoking status, hypertension, diabetes, stroke, visual acuity, and hearing loss. The percent mediation of vestibular dysfunction is calculated based on the formula (A × B) / [(A × B) + C], where A × B is the indirect effect of aging on ADL impairment medication by vestibular function, and C is the direct effect of aging on ADL impairment. ADLs = activities of daily living.
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