Understanding the Experience of Age-Related Vestibular Loss in Older Individuals: A Qualitative Study

• Published in: The patient : patient-centered outcomes research Vol. 9; no. 4; pp. 303 - 309
• Main Authors: Harun, Aisha, Li, Carol, Bridges, John F. P., Agrawal, Yuri
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.08.2016; Springer Nature B.V
• Subjects: Accidental Falls; Activities of Daily Living - psychology; Aged; Aged, 80 and over; Aging; Aging - physiology; Balance; Canals; Data analysis; Dizziness - physiopathology; Environment; Eye movements; Female; Health Administration; Health Economics; Humans; Interviews; Interviews as Topic; Laboratories; Male; Medicine; Medicine & Public Health; Meniere disease; Mental Health; Older people; Original Research Article; Patients; Pharmacoeconomics and Health Outcomes; Postural Balance - physiology; Public Health; Qualitative Research; Quality of Life Research; Research methodology; Review boards; Social Participation - psychology; Social research; Vertigo; Vestibular Diseases - complications; Vestibular Diseases - physiopathology; Healthy Aging; Semicircular Canal; Participation Restriction; Gait Speed; Benign Paroxysmal Positional Vertigo
• ISSN: 1178-1653; 1178-1661
• DOI: 10.1007/s40271-015-0156-6

Background Inner ear balance (or vestibular) function declines with age and is associated with decreased mobility and an increased risk of falls in older individuals. We sought to understand the lived experience of older adults with vestibular loss in order to improve care in this population. Methods Qualitative data were derived from semi-structured interviews of individuals aged 65 years or older presenting to the Balance and Falls Prevention Clinic from February 1, 2014 to March 30, 2015 for evaluation of age-related vestibular loss. Transcripts were analyzed using interpretive phenomenological analysis. We created a taxonomy of overarching superordinate themes based on the World Health Organization’s International Classification of Functioning, Disability, and Health (ICF) Framework, and classified key dimensions within each of these themes. Results Sixteen interviews were conducted with individuals (mean age 76.0 years, 75 % female) with age-related vestibular loss. The three superordinate themes and associated key dimensions were (1) body impairment (including depression, fatigue, fear/anxiety, and problems with concentrating and memory); (2) activity limitation and participation restriction (isolation, needing to stop in the middle of activities, reduced participation relative to expectations, reduced ability to drive or travel, and problems with bending/looking up, standing, and walking); and (3) environmental influences (needing help with daily activities). All participants reported difficulty walking. Conclusions Older adults report that vestibular loss impacts their body functioning and restricts their participation in activities. The specific key dimensions uncovered by this qualitative study can be used to evaluate care from the patient’s perspective.