Aging and the peripheral vestibular system

Whereas much has been learned about age-related auditory changes in the inner ear, relatively little is known about the aging effects on the vestibular part of the inner ear-the peripheral vestibular system. Here we review relevant literature with regard to the prevalence of vestibular dysfunction, vestibular functional and structural changes in the elderly. The prevalence of vestibular dysfunction increases with age. Functionally, as age increases, VEMP amplitudes decrease, VEMP thresholds increase, VOR gain of HIT decreases. Due to the complexity of the vestibular system, variations in subject age and measurement techniques, findings in VEMP latency and caloric tests are conflicting. To address this, a direct measure of the peripheral vestibular system should be applied. Structurally, age-related loss in vestibular ganglion and otoconia have been noted; hair cell changes are not well defined; while subcellular changes remain to be explored. Defining how the onset of vestibular dysfunction correlates with structural degeneration will offer insights into the mechanisms underlying vestibular aging.