OLDER FALLERS WITH SELF-REPORTED DIZZINESS HAVE HIGH LEVELS OF ANXIETY AND DEPRESSION AND ADOPT A STIFFENING STRATEGY WHEN EXPOSED TO OPTOKINETIC STIMULI
J. McLoughlin, C. Barr, D.L. Sturnieks, S.R. Lord, M. Crotty
J Aging Res Clin Practice 2013;2(1):148-151
Background: Objective: Many people with dizziness can develop visual dependence, an over-reliance on vision for spatial orientation. Specific visual environments including optokinetic visual stimuli can elicit feelings of disequilibrium and is known to result in increases in postural instability in patients with anxiety and vestibular dysfunction. Our study aims to investigate dizziness and postural sway in various visual conditions in a group of older people referred to a falls clinic. Design: We investigated postural sway in six visual conditions in a group of older people referred to a falls clinic with and without self-reported dizziness. Setting: South Australian Movement Analysis Centre, Repatriation General Hospital, South Australia. Participants: 100 adults (41 male) with a mean age of 82 years (range 66-94 years) participated. Measurements: We collected data on self-reported dizziness, space and motion discomfort, anxiety, depression and fear of falls. Postural sway, measured by Centre of Pressure (CoP) path length, was assessed with eyes open, eyes closed and when exposed to two linear and two rotating types of optokinetic stimuli (OKS). Results: 36 participants (36%) reported suffering dizziness. These participants had significantly higher levels of anxiety and depression, and demonstrated significantly shorter CoP path lengths for all six balance conditions compared to those without dizziness (p<0.05). The “forward” OKS, however, induced relatively greater sway in the dizzy participants. Conclusions: These findings suggest that dizziness is common in older fallers and that it contributes to a stiffening strategy to maintain standing balance. Vestibular rehabilitation using OKS for older fallers with dizziness warrants investigation in further research studies.