Research Article

Evidence of Vestibular and Balance Dysfunction in Patients With Mild Cognitive Impairment and Alzheimer’s Disease

Bosmans, Joyce1; Gommeren, Hanne1,2; Gilles, Annick1–3; Mertens, Griet1,2; Van Ombergen, Angelique1; Cras, Patrick1,4; Engelborghs, Sebastiaan5,6; Vereeck, Luc7; Lammers, Marc J.W.1,2; Van Rompaey, Vincent1,2

Author Information

1Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium

2University Department of Otorhinolaryngology-Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium

3Department of Education, Health and Social Work, University College Ghent, Ghent, Belgium

4Department of Neurology, Antwerp University Hospital and Born-Bunge Institute, University of Antwerp, Antwerp, Belgium

5Department of Neurology, Universitair Ziekenhuis Brussel and Center for Neurosciences, Vrije Universiteit Brussel, Brussels, Belgium

6Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium

7Department of Rehabilitation Sciences and Physiotherapy, MOVANT, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium.

Received December 8, 2022; accepted May 22, 2023; published online ahead of print July 24, 2023.

This work was supported by a Fonds voor Wetenschappelijk Onderzoek Fundamental Research Project grant [G042819N3]. This funding source had no involvement in the preparation of this article.

The authors have no conflicts of interest to disclose.

Address for correspondence: Vincent Van Rompaey, Department of Translational Neuroscience, Faculty of Medicine and Health Sciences, University of Antwerp. E-mail: [email protected]

Ear and Hearing 45(1):p 53-61, January/February 2024. | DOI: 10.1097/AUD.0000000000001401

Abstract

Objectives: 

Given the expected rise in dementia prevalence, early diagnosis is vital. As a growing body of literature has identified a potential association between vestibular function and cognition, vestibular assessment may aid in early screening. The aim of the study was to better comprehend the proposed association between vestibular function and Alzheimer’s disease (AD) by comparing vestibular parameters (vestibular function testing and clinical balance measures) between a group with mild cognitive impairment (MCI), AD, and healthy controls with age-normal cognition.

Design: 

Cross-sectional analysis of the GECkO study, an ongoing prospective single-center longitudinal cohort study. This study included 100 older adults (55 to 84 years). A total of 33 participants with MCI, 17 participants with AD, and 50 participants of age, sex, and hearing-matched healthy controls were included.

Results: 

Participants with AD demonstrated a delayed latency of the p13 component measured by cervical vestibular-evoked myogenic potentials (cVEMP) compared with healthy controls and participants with MCI. Other measures including n23 latency, presence of intact responses, rectified amplitude, mean rectified voltage (measured by cVEMP) and lateral vestibulo-ocular reflex gain (measured by video Head Impulse Test [vHIT]) did not differ between groups. The Timed Up and Go (TUG), Performance-Oriented Mobility Assessment—Balance subscale (POMA-B), and Functional Gait Assessment (FGA) differed significantly between the three groups. Here, more cognitively impaired groups were associated with worse clinical balance scores.

Conclusions: 

Vestibular and balance deficits were more prevalent in groups with increasing cognitive decline. Regarding vestibular function testing, p13 latency as measured by cVEMP was delayed in participants with AD. Other cVEMP or vHIT measures did not differ between groups. All three clinical balance assessments (TUG, POMA-B, and FGA) resulted in worse scores along the AD continuum. Future research integrating vestibular parameters that add value (including otolith function testing, balance, and spatial navigation) is recommended to validate the association between vestibular function and cognition while avoiding redundant testing.

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