Inner ear damage increases risk of falling in Alzheimer’s patients

April 14, 2022
Inner ear damage increases risk of falling in Alzheimer’s patients

Damage or impairment to the vestibular system in the inner ear – a common cause of dizziness, vertigo, and balance issues – has been found to elevate the risk for falls in patients with Alzheimer’s disease (Alzheimer’s). According to a research team at Johns Hopkins Medicine University School of Medicine (Johns Hopkins), impairment of the vestibular system was linked to a 50% increase in the risk of falling for Alzheimer’s patients compared to those who had healthy vestibular function.

The vestibular system consists of a group of canals and bony structures deep in the inner ear, which controls balance. The research team had studied this system in about 50 people with the neurological disease, which robs a person of their memory and other important mental functions – falls from loss of balance contribute to substantial disability in patients as well.

The researchers used devices that tracked responses to eye and head movement to stimulate and mirror vestibular function. Subjects who had vestibular function impairment on these tests were noticed to be 50% more likely to fall compared to subjects with normal vestibular function.

“Falls are a major problem in people with Alzheimer’s disease, who fall at twice the rate compared with healthy older adults, and this often leads to injury, nursing home placement and early mortality,” said Dr. Yuri Agrawal, Professor of Otolaryngology – head and neck surgery at Johns Hopkins.

Dr. Agrawal explained that the loss of vestibular function leads to an increased sway, causing unstable balance which in turn leads to more falls.

“We call the vestibular system the sixth hidden sense because it functions almost at a subconscious level. It’s always ‘on’ and operates normally to keep us oriented as we move through space, sensing what’s up and what’s down and around us. The system automatically feeds that information to the brain as other sensory organs such as the eyes or ears do. But unlike closing one’s eyes or plugging one’s ears, people cannot willfully control it. So, when its impaired, people experience vertigo, a disorienting, inability to navigate the world.”

She suggests additional attention be paid to the care of the vestibular system alongside cognitive impairment treatments for patients with Alzheimer’s, and alluded to an ongoing clinical trial for vestibular therapy to prevent falls in these patients.

“Vestibular impairment is treatable with balance exercises performed under the care of a physical therapist,” Dr. Agrawal concluded. “That could enhance the quality of life for both patients and caregivers.”

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