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

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 vit...

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Autores principales: Bosmans, Joyce, Gommeren, Hanne, Mertens, Griet, Cras, Patrick, Engelborghs, Sebastiaan, Van Ombergen, Angelique, Vereeck, Luc, Gilles, Annick, Van Rompaey, Vincent
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Medical Association 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9204614/
https://www.ncbi.nlm.nih.gov/pubmed/35708675
http://dx.doi.org/10.1001/jamaoto.2022.1303
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author Bosmans, Joyce
Gommeren, Hanne
Mertens, Griet
Cras, Patrick
Engelborghs, Sebastiaan
Van Ombergen, Angelique
Vereeck, Luc
Gilles, Annick
Van Rompaey, Vincent
author_facet Bosmans, Joyce
Gommeren, Hanne
Mertens, Griet
Cras, Patrick
Engelborghs, Sebastiaan
Van Ombergen, Angelique
Vereeck, Luc
Gilles, Annick
Van Rompaey, Vincent
author_sort Bosmans, Joyce
collection PubMed
description 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 (r(32) = 0.51; 95% CI, 0.20 to 0.72; η(2) = 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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spelling pubmed-92046142022-07-05 Associations of Bilateral Vestibulopathy With Cognition in Older Adults Matched With Healthy Controls for Hearing Status Bosmans, Joyce Gommeren, Hanne Mertens, Griet Cras, Patrick Engelborghs, Sebastiaan Van Ombergen, Angelique Vereeck, Luc Gilles, Annick Van Rompaey, Vincent JAMA Otolaryngol Head Neck Surg Original Investigation 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 (r(32) = 0.51; 95% CI, 0.20 to 0.72; η(2) = 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. American Medical Association 2022-06-16 2022-08 /pmc/articles/PMC9204614/ /pubmed/35708675 http://dx.doi.org/10.1001/jamaoto.2022.1303 Text en Copyright 2022 Bosmans J et al. JAMA Otolaryngology–Head & Neck Surgery. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the CC-BY License.
spellingShingle Original Investigation
Bosmans, Joyce
Gommeren, Hanne
Mertens, Griet
Cras, Patrick
Engelborghs, Sebastiaan
Van Ombergen, Angelique
Vereeck, Luc
Gilles, Annick
Van Rompaey, Vincent
Associations of Bilateral Vestibulopathy With Cognition in Older Adults Matched With Healthy Controls for Hearing Status
title Associations of Bilateral Vestibulopathy With Cognition in Older Adults Matched With Healthy Controls for Hearing Status
title_full Associations of Bilateral Vestibulopathy With Cognition in Older Adults Matched With Healthy Controls for Hearing Status
title_fullStr Associations of Bilateral Vestibulopathy With Cognition in Older Adults Matched With Healthy Controls for Hearing Status
title_full_unstemmed Associations of Bilateral Vestibulopathy With Cognition in Older Adults Matched With Healthy Controls for Hearing Status
title_short Associations of Bilateral Vestibulopathy With Cognition in Older Adults Matched With Healthy Controls for Hearing Status
title_sort associations of bilateral vestibulopathy with cognition in older adults matched with healthy controls for hearing status
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9204614/
https://www.ncbi.nlm.nih.gov/pubmed/35708675
http://dx.doi.org/10.1001/jamaoto.2022.1303
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