• Matthew Bryan Liston, Doris-Eva Bamiou, Finbarr Martin, Adrian Hopper, Nehzat Koohi, Linda Luxon, and Marousa Pavlou.
• Centre of Human and Aerospace Physiological Sciences, King's College London, London, UK.
• Age Ageing. 2014 Jan 1; 43 (1): 38-43.

Backgroundvestibular disorders are common in the general population, increasing with age. However, it is unknown whether older adults who fall have a higher proportion of vestibular impairment compared with age-matched older adult non-fallers.Objectiveto identify whether a greater proportion of older adult fallers have a peripheral vestibular impairment compared with age-matched healthy controls.Designcase-controlled study.Settingtertiary falls and neuro-otology clinics and local community centres, London, UK.Participants And Methodscommunity-dwelling older adults experiencing: (i) ≥2 unexplained falls within the previous 12-months (Group F, n = 25), (ii) a confirmed peripheral vestibular disorder (Group PV, n = 15) and (iii) healthy non-fallers (Group H, n = 16). All the participants completed quantitative vestibular function tests, the functional gait assessment (FGA), physiological profile assessment (PPA) and subjective measures for common vestibular symptoms (i.e. giddiness), balance confidence during daily activities and psychological state.Resultsa clinically significant vestibular impairment was noted for 80% (20/25) of Group F compared with 18.75% (3/16) for Group H (P < 0.01). Group F performed less well in complex gait tasks (FGA), and reported a greater number of falls than both Groups H and PV (P < 0.05). Vestibular symptom scores showed no significant difference between Groups F and PV.Conclusionvestibular dysfunction is significantly more prevalent in older adult fallers versus non-fallers. Individuals referred to a falls clinic are older, more impaired and report more falls than those referred to a neuro-otology department. A greater awareness of vestibular impairments may lead to more effective management and treatment for older adult fallers.

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