Inner ear balance (or vestibular) function declines with age and is associated with decreased mobility and an increased risk of falls in older individuals. We sought to understand the lived experience of older adults with vestibular loss in order to improve care in this population.
Qualitative data were derived from semi-structured interviews of individuals aged 65 years or older presenting to the Balance and Falls Prevention Clinic from February 1, 2014 to March 30, 2015 for evaluation of age-related vestibular loss. Transcripts were analyzed using interpretive phenomenological analysis. We created a taxonomy of overarching superordinate themes based on the World Health Organization’s International Classification of Functioning, Disability, and Health (ICF) Framework, and classified key dimensions within each of these themes.
Sixteen interviews were conducted with individuals (mean age 76.0 years, 75 % female) with age-related vestibular loss. The three superordinate themes and associated key dimensions were (1) body impairment (including depression, fatigue, fear/anxiety, and problems with concentrating and memory); (2) activity limitation and participation restriction (isolation, needing to stop in the middle of activities, reduced participation relative to expectations, reduced ability to drive or travel, and problems with bending/looking up, standing, and walking); and (3) environmental influences (needing help with daily activities). All participants reported difficulty walking.
Older adults report that vestibular loss impacts their body functioning and restricts their participation in activities. The specific key dimensions uncovered by this qualitative study can be used to evaluate care from the patient’s perspective.
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A. Harun contributed to the study design, data acquisition, data analysis and interpretation, and drafting of the manuscript. C. Li contributed to the study design, data acquisition, data analysis, and drafting of the manuscript. J. Bridges contributed to study design and critical revision of the manuscript. Y. Agrawal contributed to study design, data analysis, and critical revision of the manuscript. Y. Agrawal had full access to all of the study data and takes responsibility for the integrity of the data and accuracy of the data analysis.
Aisha Harun was funded by a T32 Award (5T32DC000027-25). Yuri Agrawal was funded by a NIH K23 Award (5K23DC013056-02). Aisha Harun, Carol Li, John F. P. Bridges, and Yuri Agrawal have no conflicts of interest to report. The hospital institutional review board approved this study (Baltimore, MD: study number CR00007456) and the study was performed in accordance with the ethical standards of the Declaration of Helsinki. Informed consent was obtained from all individuals who participated in the study.
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Harun, A., Li, C., Bridges, J.F.P. et al. Understanding the Experience of Age-Related Vestibular Loss in Older Individuals: A Qualitative Study. Patient 9, 303–309 (2016). https://doi.org/10.1007/s40271-015-0156-6