Visual and vestibular functions in healthy older adults
Jonathan Green, Ellie Edlmann, Jonathan Marsden, Gunnar Schmidtmann
This study aimed to investigate visual and vestibular functions in healthy older adults. We focused on functions that might reveal clinically important insights, especially concerning cortical changes expected in patients with mild traumatic brain injuries. A total of 50 older (mean age: 75, SD: ±7.75; range 62-95 years; 38 females) healthy participants were recruited and tested with a wide variety of visual and vestibular tests. A new tablet-based visual testing platform (PerZeption Inc.) was used to efficiently and quickly measure near visual acuity, the full contrast sensitivity function, and global motion coherence thresholds. Results showed normal, age-appropriate performance across all visual functions. To assess vestibular functions, all subjects were assessed with Dix-Hallpike, Supine Head-roll, and Head Impulse test (HIT). 7% of the subjects showed nystagmus, and 13% reported dizziness following Dix-Hallpike. 9% of the subjects reported dizziness following Supine Head-roll, and 17% showed saccades following HIT. The Rivermead Post-concussion Symptoms Questionnaire results showed that 20% of subjects scored between 16-35, indicative of post-concussion syndrome, despite a non-existent concussion. Subjects also underwent Vestibular Oculomotor Screening (VOMS), assessing headache, dizziness, nausea and fogginess (HDNF) provoked by Smooth Pursuit (SP), Horizontal/Vertical Saccades (H/VS), Vestibulo-ocular Reflex (VOR) and Visual Motion Sensitivity (VMS) tests. SP provoked HDNF in 6% of subjects, and saccades were observed in 46%. For H/VS, 4% were symptomatic, and inaccuracy was observed in 10%. VOR provoked HDNF in 10% and VMS in 19%. Overall, 25% reported mild-moderate HDNF symptoms for at least one component of VOMS. The most common HDNF symptom was dizziness. In summary, healthy older adults showed a higher rate of vestibular dysfunction than anticipated and symptoms which would be considered comparable to the effects of concussion in head-injured patients.
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