The vestibular system has an important role to play in movement. The vestibular system helps to control posture and gait as well as maintain balance and orientation by sensing head movement and coordinating eye and postural movements, all factors that support falls prevention.
In addition, hearing or hearing loss can influence the quality of life of an older adult. Hearing loss can affect factors such as communication, cognition, and social participation.
More than one in two people who fall have signs of vestibular dysfunction.
Risk factors for falls in older adults with impaired vestibular function
Slower gait speed
Vestibular function declines with age and can be associated with deficits in gait, unsteadiness, and an increased risk of falls.
Lower standing balance
Vestibular disorders can cause dizziness, vertigo, and imbalance.
An older adult with reduced otolith (the part of the inner ear that can sense linear movements and gravity) function can experience increased postural sway whilst standing, a known risk factor for falls.
Postural instability
Reduced auditory cues, or hearing, can contribute to postural instability.
Reduced levels of physical activity
Individuals with hearing impairments have also been found to have lower walking endurance and lower physical activity levels, impacting the involvement in strength and balance falls prevention strategies.
How can I help older adults with impaired vestibular function?
The World Guidelines for Falls Prevention and Management for Older Adults recommend that the management of vestibular issues is considered as part of a multifactorial approach to falls prevention. This may involve:
- Vestibular rehabilitation, including physiotherapy and occupational therapy intervention. Vestibular rehabilitation has been proven effective in treating stable vestibular problems in all ages.
- Prescribing appropriate medication for inner ear viral infections. Individuals taking the appropriate medication within three days of the onset of infection has been shown to improve vestibular function.
- Ensuring the consistent use of hearing aids by older adults with hearing loss. This has been found to decrease the likelihood of the individual experiencing a fall.
Screening and health checks for older adults
The Falls Guidelines for Community Care recommends good practice points for vestibular function and minimise the risk of falls due to dizziness:
- Encourage older people to have annual hearing assessments and management with an audiologist to maximise hearing. Support the older person to see an audiologist when required.
- Encourage older people to wear their hearing aids when mobilising. Ensure that the hearing aids are working.
- Implement strategies to maximise independence with older people who have hearing impairment. If the older person has fallen, facilitate access to an audiologist for a detailed assessment and fall-specific hearing examination.
- Use hearing devices (such as a pocket talker that amplifies sound closest to the listener while reducing background noise) or a hearing loop (a sound system that can broadcast to hearing aids) to communicate with an older person with a hearing impairment, as required and in line with the older person’s preferences.
Who can I collaboratively work with to support older adults with their vestibular health?
A multidisciplinary team to support older adults with their vestibular health or dysfunction may consist of a GP, Audiologist, and Otologist.
More information
For more information, resources, and support about vestibular and ear health, visit the Ear Science Institute Australia website.
