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. 2022 Aug 1;148(8):731-739.
doi: 10.1001/jamaoto.2022.1303.

Associations of Bilateral Vestibulopathy With Cognition in Older Adults Matched With Healthy Controls for Hearing Status

Joyce Bosmans  1 , Hanne Gommeren  1   2 , Griet Mertens  1   2 , Patrick Cras  1   3 , Sebastiaan Engelborghs  4   5 , Angelique Van Ombergen  1 , Luc Vereeck  6 , Annick Gilles  1   2   7 , Vincent Van Rompaey  1   2
Affiliations

Associations of Bilateral Vestibulopathy With Cognition in Older Adults Matched With Healthy Controls for Hearing Status

Joyce Bosmans et al. JAMA Otolaryngol Head Neck Surg. .

Abstract

Importance: Recent literature suggests there may be a significant effect of the vestibular system on cognition and visuospatial processing. Given the increasing prevalence of dementia and individuals at risk for it, exploring possible modifiable risk factors, including vestibular dysfunction, is vital.

Objectives: To explore the association of bilateral vestibulopathy (BV) with cognitive function in older adults, taking hearing status into account, and to explore multiple vestibular characteristics and their potential associations with cognition in patients with BV.

Design, setting, and participants: This cross-sectional study assessed older adults (age 55-84 years) with diagnosed BV from a single center using baseline measurements from the Gehoor, Evenwicht en Cognitie (GECKO) study, an ongoing prospective longitudinal cohort study. Each participant was individually matched with a healthy control based on age, sex, and hearing performance. Data were analyzed in January 2022.

Main outcomes and measures: The primary outcome measure was cognition, measured by the Repeatable Battery for the Assessment of Neuropsychological Status for Hearing-Impaired Individuals (RBANS-H).

Results: A total of 68 patients were assessed, including 34 patients with BV (mean [SD] age, 63.3 [6.0] years; 18 [53%] men) matched with 34 control individuals without BV. Overall, participants with BV had a clinically meaningful lower score on the RBANS-H total scale compared with those without BV (mean [SD] score, 98.62 [12.70] vs 105.91 [11.03]). This decline was most pronounced in the subdomains of immediate memory (mean [SD] score, 107.74 [10.66] vs 112.26 [10.66]), visuospatial cognition (mean [SD] score, 90.06 [13.34] vs 100.47 [13.91]), and attention (mean [SD] score, 94.79 [16.39] vs 102.06 [12.97]). There were no differences in language or delayed memory subdomains. Within the BV population, 1 vestibular parameter (the Performance-Oriented Mobility Assessment, in particular the balance subscale) was associated with lower cognitive scores (r32 = 0.51; 95% CI, 0.20 to 0.72; η2 = 0.26). Other vestibular parameters, including measurements of the peripheral vestibular end organ and questionnaires, showed no association.

Conclusions and relevance: These findings suggest there was an association between vestibular loss and cognitive impairment. Further research on the causal mechanisms underlying this association and the possible impact of vestibular rehabilitation on cognition is needed.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Engelborghs reported receiving grants from Janssen Pharmaceutica, ADx Neurosciences, and icometrix and personal fees from Biogen and Roche outside the submitted work. Dr Van Rompaey reported receiving grants from Cochlear and Medel outside the submitted work. No other disclosures were reported.

Figures

Figure.
Figure.. Comparison of Repeatable Battery for the Assessment of Neuropsychological Status for Hearing-Impaired Individuals (RBANS-H) Scores Between Individuals With Bilateral Vestibulopathy and Their Matched Healthy Controls
B, Whiskers indicate range; boxes, IQR; bold line, median. Small, medium, and large indicate clinically meaningful Cohen d effect sizes.
See this image and copyright information in PMC

References

    1. Bigelow RT, Agrawal Y. Vestibular involvement in cognition: visuospatial ability, attention, executive function, and memory. J Vestib Res. 2015;25(2):73-89. doi:10.3233/VES-150544 - DOI - PubMed
    1. Smith PF, Zheng Y. From ear to uncertainty: vestibular contributions to cognitive function. Front Integr Neurosci. 2013;7:84. doi:10.3389/fnint.2013.00084 - DOI - PMC - PubMed
    1. Zheng Y, Goddard M, Darlington CL, Smith PF. Bilateral vestibular deafferentation impairs performance in a spatial forced alternation task in rats. Hippocampus. 2007;17(4):253-256. doi:10.1002/hipo.20266 - DOI - PubMed
    1. Zheng Y, Goddard M, Darlington CL, Smith PF. Long-term deficits on a foraging task after bilateral vestibular deafferentation in rats. Hippocampus. 2009;19(5):480-486. doi:10.1002/hipo.20533 - DOI - PubMed
    1. Baek JH, Zheng Y, Darlington CL, Smith PF. Evidence that spatial memory deficits following bilateral vestibular deafferentation in rats are probably permanent. Neurobiol Learn Mem. 2010;94(3):402-413. doi:10.1016/j.nlm.2010.08.007 - DOI - PubMed

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