Proposal for a screening protocol for falls among old subjects attending the audio-vestibular clinic

Abstract

Abstract Background Older adults suffer from falls. 30% of the elderly fall annually in United States of America (Otorhinolaryngol Head Neck Surg. 5:1-4 2020). Falls have also cost society and people heavily. The aim of this study is to identify fall risk factors in elderly visiting the audio-vestibular clinic and propose a screening strategy. Methods The study included 500 elderly participants over 60 years old who visited the audio-vestibular clinic for hearing and/or vestibular evaluations. All participants in this study underwent a full audiological and neuro-otological history, general examination, otological examination, audiological evaluation, and office vestibular testing. Results One hundred fifty-nine out of 500 (32%) of the study group had a history of vertigo, and 153 out of 500 (31%) had fallen at least once in the past two years. Dizziness and age were significantly associated. Dizziness was more common in people over 70 years old. Similar results were found for the fall history and age. Falls were more common in elderly participants with dizziness. 25% of participants with a history of falls had dizziness, compared to 14.5 percent of those without. Systemic diseases and falls were significantly associated. Falls and abnormal office vestibular test results were statistically significant. Multiple regression analysis showed that Diabetes Mellitus, hypertension, orthostatic hypotension, positional and positioning nystagmus, Romberg and Fukuda tests, and falls were all associated. Multiple risk factors cause older adult to fall. Dizziness increases the risk of falling, especially in the elderly. In our study, hypertension and diabetes were the two greatest independent fall risk factors. Office vestibular tests can detect elderly fallers.