Oral Presentation Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2023

Vestibular dysfunction and falls (#48)

Ann Rahmann 1 2 , Kelly Costa 3
  1. Metro North Health, Brighton, QLD, Australia
  2. School of Allied Health, Australian Catholic University, Banyo, Queensland, Australia
  3. The Prince Charles Hospital, Metro North Health, Chermside, Queensland, Australia

Background: Dysfunction of the vestibular system in the inner ear is common with ageing and increases the risk of falls. Appropriately identifying and managing vestibular dysfunction in older adults reduces the incidence of falls. Subjective vertigo is a key indicator for vestibular physiotherapy assessment and management. However, a research project undertaken at Brighton Rehabilitation Unit, in Metro North completed routine vestibular physiotherapy assessment of older inpatients. More than 70% of the sixty older adults included didn’t report dizziness on moving so would not normally have been assessed. All but one of the older adults had vestibular dysfunction on clinical assessment. Many older adults seen in hospital and community contexts, particularly after a fall or fracture, are unable to move quickly enough to provoke symptoms of dizziness or vertigo so are not referred for vestibular physiotherapy assessment and management. This common underlying risk factor for further falls, ongoing imbalance and reduced mobility is therefore not addressed.

Session outline: Two Advanced Vestibular Physiotherapists will discuss and demonstrate the key clinical physiotherapy assessment and management priorities in two different clinical contexts.

  1. Emergency Dept / acute hospital context when older adults present with emergent vertigo and / or dizziness.
  2. Community context / outside the hospital setting when older adults present with imbalance, reduced mobility and increased risk of falls.

Clinical discussion points and practical demonstrations will highlight the contribution of vestibular physiotherapy to assist the medical team with clinical assessment, differential diagnosis, and management in each context. The session will highlight evidence based, clinical assessments that can be used by the medical team to identify older adults who would benefit from vestibular physiotherapy.