The social problem of presbystasis and the role of vestibular rehabilitation in elderly patients: a review

The term “presbystasis” refers to a common clinical condition in the elderly, characterised by a multifactorial and progressive impairment of balance. The pathophysiology may be related to various concomitant factors including central nervous system diseases, peripheral neuropathy, osteoarticular disorders (leading to a reduction of the speed gait), and cardiovascular or visual disorders, but it may also be a consequence of deficits of the peripheral or central vestibular system (which is generally represented by a bilateral and symmetric vestibular dysfunction). Benign paroxysmal positional vertigo (BPPV) is far from being rare in subjects over the age of 70 years. Nowadays, presbystasis represents one of the main causes of accidental falls in the elderly, leading to a reduction in quality of life and life expectancy. The aim of our work was to review the current literature on presbystasis, focusing on the role of the vestibular system in the pathogenesis and on the possibilities offered by vestibular rehabilitation in the management of these subjects. Other clinical conditions related to the disorder are also discussed.