Falls incidence and characteristics in bilateral vestibulopathy: relationships with age, concerns about falls and balance

Introduction: Bilateral vestibulopathy (bilateral loss of vestibular function; BVP) significantly impairs balance, leading to an elevated falls risk. Age, balance performance and concerns about falling may further exacerbate these issues. This study describes fall incidence characteristics among people with BVP and relates these to age, concern about falling and objective balance performance.

Method: 51 participants with BVP completed a standardised 12-month fall history questionnaire, the Falls Efficacy Scale–International (FES-I) and the Mini-BESTest to collect data on fall incidents, causes, locations and injuries, as well as fall-related concerns, and balance performance. Differences in these outcomes among non-fallers, single-fallers and multiple-fallers were analysed using Kruskal-Wallis tests. Mann-Whitney U tests were used to examine differences between non-fallers and fallers (one or more falls).

Results: Overall, participants were 57.9±12.6 years of age. 27 participants had no recent falls (males: 16, females: 11). 24 participants (males: 13, females: 11) reported one or more recent falls. 6 participants fell once (males: 2, females: 4) and 18 fell at least twice (males: 11, females: 7). There were no significant differences among non-fall, single-fall, and multiple-fall groups in age, Mini-BESTest total score or FES-I (H(2)=0.77, P=0.681; H(2)=1.45, P=0.484; H(2)=3.27, P=0.195, respectively). There were no significant differences between no-fall and falls groups in age, Mini-BESTest total score or FES-I (U=292, P=0.552; U=242, P=0.249; U=212, P=0.128, respectively). 13 participants mentioned injuries, which included bruises (n=12), cuts/grazes (n=10), back pain (n=2), broken bones (n=2). Falls most commonly occurred inside (on the one ground level, n=12), with the most common causes being “lost balance” (n=23), “tripped” (n=4), “slipped” (n=4).

Conclusions:
Participants with BVP demonstrate moderate falls incidence, with many experiencing multiple falls and fall-related injuries. Age, concern about falls and balance performance did not differ between groups, indicating that additional assessments might be needed to assess falls risk in this population.