Predicting Fall Risks in an Elderly Population: Computer Dynamic Posturography Versus Electronystagmography Test Results

• Published in: The Laryngoscope 2001-09, Vol.111 (9), p.1528-1532
• Main Authors: Girardi, Marian, Konrad, Horst R., Amin, Manali, Hughes, Larry F.
• Format: Article
• Language: English
• Subjects: Accidental Falls - prevention & control; Accidental Falls - statistics & numerical data; Age Distribution; Aged; Analysis of Variance; balance; Biological and medical sciences; Case-Control Studies; Diagnosis, Computer-Assisted - methods; Diagnosis, Computer-Assisted - standards; Ear, auditive nerve, cochleovestibular tract, facial nerve: diseases, semeiology; elderly; Electronystagmography - methods; Electronystagmography - standards; Falls; Female; Geriatric Assessment; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Non tumoral diseases; Otorhinolaryngology functional investigation (larynx, voice, audiometry, vestibular function, equilibration...); Otorhinolaryngology. Stomatology; Postural Balance; Posture; posturography; Predictive Value of Tests; Risk Assessment; Risk Factors; Sensation Disorders - complications; Sensation Disorders - diagnosis; Sensation Disorders - physiopathology; Sex Distribution; vestibular testing
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1097/00005537-200109000-00008

Objectives/Hypothesis Falls are the leading cause of morbidity and mortality for persons aged 65 years and older, with more than 2 million people falling and sustaining serious injury annually. This study compared computer dynamic posturography (CDP) and electronystagmography (ENG) results as predictors of falls. Study Design Retrospective. Methods Thirty‐three patients over the age of 65 years who presented to a balance disorders and falls prevention clinic were used for this study (22 women and 11 men, with an average age of 78.0 y and a mean fall rate of 3.5 times). All had experienced at least one fall in the year before visiting the clinic and were tested with both CDP and ENG. The CDP results were divided into subcategories (sensory organization testing and limits of stability); ENG results were divided into four categories (ocular motor, rotational chair, positional, and caloric studies). Results Test findings were classified as normal or abnormal based on age‐matched normative data. Of the patients in the study, 27.3% were normal for one type of testing and abnormal for the other. Twenty‐six patients (78.8%) had abnormal results on CDP, and 20 individuals (60.6%) showed ENG abnormalities (42.4% for ocular motor, 28.6% for positional, 13.6% for caloric, and 11.2% for rotational chair studies). The limits of stability category was significant in predicting multiple falls. Conclusion For this population, CDP was determined to be a more sensitive test for identifying patients who have fallen, with limits of stability testing the most significant part of the CDP battery; for ENG studies, the best falls indicator was the ocular motor battery.