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Neurogeriatrie

Schwindel, Dysbalance, Benommenheit und Gangunsicherheit im Alter

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Zusammenfassung

Schwindel ist eines der häufigsten Leitsymptome des älteren Patienten und ist oft durch eine eingeschränkte Aktivität im Alltag und psychiatrische Komorbiditäten charakterisiert. Schwindel im Alter ist ein Komplex einzelner differenzierbarer Funktionsstörungen. Eine ursächliche oder symptomatische Therapie der einzelnen Ursachen führt zu einer gesteigerten Lebensqualität.

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Literatur

  1. Furman JM, Raz Y, Whitney SL. Geriatric vestibulopathy assessment and management. Current opinion in otolaryngology & head and neck surgery. 2010;18(5):386–91.

    Article  Google Scholar 

  2. Tinetti ME, Williams CS, Gill TM. Dizziness among older adults: a possible geriatric syndrome. Annals of internal medicine. 2000;132(5):337–44.

    Article  CAS  PubMed  Google Scholar 

  3. Neuhauser HK. Epidemiology of vertigo. Current opinion in neurology. 2007;20(1):40–6.

    Article  PubMed  Google Scholar 

  4. Jonsson R, Sixt E, Landahl S, Rosenhall U. Prevalence of dizziness and vertigo in an urban elderly population. Journal of vestibular research: equilibrium & orientation. 2004;14(1):47–52.

    Google Scholar 

  5. Lin HW, Bhattacharyya N. Balance disorders in the elderly: epidemiology and functional impact. The Laryngoscope. 2012;122(8):1858–61.

    Article  PubMed  Google Scholar 

  6. Mueller M, Strobl R, Jahn K, Linkohr B, Peters A, Grill E. Burden of disability attributable to vertigo and dizziness in the aged: results from the KORA-Age study. European journal of public health. 2014;24(5):802–7.

    Article  PubMed  Google Scholar 

  7. Mueller M, Strobl R, Jahn K, Linkohr B, Ladwig KH, Mielck A, et al. Impact of vertigo and dizziness on self-perceived participation and autonomy in older adults: results from the KORA-Age study. Quality of life research: an international journal of quality of life aspects of treatment, care and rehabilitation. 2014;23(8):2301–8.

    Article  Google Scholar 

  8. Ekwall A, Lindberg A, Magnusson M. Dizzy - why not take a walk? Low level physical activity improves quality of life among elderly with dizziness. Gerontology. 2009;55(6):652–9.

    Article  PubMed  Google Scholar 

  9. de Moraes SA, Soares WJ, Ferriolli E, Perracini MR. Prevalence and correlates of dizziness in community-dwelling older people: a cross sectional population based study. BMC geriatrics. 2013;13:4.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Dros J, Maarsingh OR, Beem L, van der Horst HE, {ter} Riet G, Schellevis FG, et al. Functional prognosis of dizziness in older adults in primary care: a prospective cohort study. Journal of the American Geriatrics Society. 2012;60(12):2263–9.

    Article  PubMed  Google Scholar 

  11. Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age and ageing. 2006;35 Suppl 2:ii37–ii41.

    PubMed  Google Scholar 

  12. Agrawal Y, Carey JP, Della Santina CC, Schubert MC, Minor LB. Disorders of balance and vestibular function in US adults: data from the National Health and Nutrition Examination Survey, 2001-2004. Archives of internal medicine. 2009;169(10):938–44.

    Article  PubMed  Google Scholar 

  13. Boelens C, Hekman EE, Verkerke GJ. Risk factors for falls of older citizens. Technology and health care: official journal of the European Society for Engineering and Medicine. 2013;21(5):521–33.

    CAS  Google Scholar 

  14. Kao AC, Nanda A, Williams CS, Tinetti ME. Validation of dizziness as a possible geriatric syndrome. Journal of the American Geriatrics Society. 2001;49(1):72–5.

    Article  CAS  PubMed  Google Scholar 

  15. Whitney SL, Marchetti GF, Schade A, Wrisley DM. The sensitivity and specificity of the Timed „Up & Go“ and the Dynamic Gait Index for self-reported falls in persons with vestibular disorders. Journal of vestibular research: equilibrium & orientation. 2004;14(5):397–409.

    Google Scholar 

  16. Hotson JR, Baloh RW. Acute vestibular syndrome. The New England journal of medicine. 1998;339(10):680–5.

    Article  CAS  PubMed  Google Scholar 

  17. Newman-Toker DE, Kerber KA, Hsieh YH, Pula JH, Omron R, Saber Tehrani AS, et al. HINTS outperforms ABCD2 to screen for stroke in acute continuous vertigo and dizziness. Academic emergency medicine: official journal of the Society for Academic Emergency Medicine. 2013;20(10):986–96.

    Article  Google Scholar 

  18. Tarnutzer AA, Berkowitz AL, Robinson KA, Hsieh YH, Newman-Toker DE. Does my dizzy patient have a stroke? A systematic review of bedside diagnosis in acute vestibular syndrome. CMAJ: Canadian Medical Association journal = journal de l’Association medicale canadienne. 2011;183(9):E571–92.

    Article  Google Scholar 

  19. van der Zaag-Loonen HJ, van Leeuwen RB, Bruintjes TD, van Munster BC. Prevalence of unrecognized benign paroxysmal positional vertigo in older patients. European archives of oto-rhino-laryngology: oficial journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS): affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 2014.

  20. McClure JA. Horizontal canal BPV. The Journal of otolaryngology. 1985;14(1):30–5.

    CAS  PubMed  Google Scholar 

  21. Brandt T, Steddin S. Current view of the mechanism of benign paroxysmal positioning vertigo: cupulolithiasis or canalolithiasis? Journal of vestibular research: equilibrium & orientation. 1993;3(4):373–82.

    CAS  Google Scholar 

  22. Bachor E, Wright CG, Karmody CS. The incidence and distribution of cupular deposits in the pediatric vestibular labyrinth. The Laryngoscope. 2002;112(1):147–51.

    Article  PubMed  Google Scholar 

  23. Vibert D, Kompis M, Hausler R. Benign paroxysmal positional vertigo in older women may be related to osteoporosis and osteopenia. The Annals of otology, rhinology, and laryngology. 2003;112(10):885–9.

    Article  PubMed  Google Scholar 

  24. Brandt T, Huppert D, Hecht J, Karch C, Strupp M. Benign paroxysmal positioning vertigo: a long-term follow-up (6-17 years) of 125 patients. Acta oto-laryngologica. 2006;126(2):160–3.

    Article  PubMed  Google Scholar 

  25. Zingler VC, Cnyrim C, Jahn K, Weintz E, Fernbacher J, Frenzel C, et al. Causative factors and epidemiology of bilateral vestibulopathy in 255 patients. AnnNeurol. 2007;61(6):524–32.

    Google Scholar 

  26. Migliaccio AA, Halmagyi GM, McGarvie LA, Cremer PD. Cerebellar ataxia with bilateral vestibulopathy: description of a syndrome and its characteristic clinical sign. Brain: a journal of neurology. 2004;127(Pt 2):280–93.

    Article  Google Scholar 

  27. Szmulewicz DJ, Waterston JA, MacDougall HG, Mossman S, Chancellor AM, McLean CA, et al. Cerebellar ataxia, neuropathy, vestibular areflexia syndrome (CANVAS): a review of the clinical features and video-oculographic diagnosis. Annals of the New York Academy of Sciences. 2011;1233:139–47.

    Article  PubMed  Google Scholar 

  28. Schniepp R, Wuehr M, Neuhaeusser M, Benecke AK, Adrion C, Brandt T, et al. 4-aminopyridine and cerebellar gait: a retrospective case series. Journal of neurology. 2012;259(11):2491–3.

    Article  PubMed  Google Scholar 

  29. Wuehr M, Schniepp R, Schlick C, Huth S, Pradhan C, Dieterich M, et al. Sensory loss and walking speed related factors for gait alterations in patients with peripheral neuropathy. Gait & posture. 2014;39(3):852–8.

    Article  Google Scholar 

  30. Hillier SL, McDonnell M. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Clinical otolaryngology: official journal of ENT-UK; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery. 2011;36(3):248–9.

    Article  Google Scholar 

  31. Dieterich M, Brandt T. Ocular torsion and tilt of subjective visual vertical are sensitive brainstem signs. Annals of neurology. 1993;33(3):292–9.

    Article  CAS  PubMed  Google Scholar 

  32. Ghosh BC, Carpenter RH, Rowe JB. A longitudinal study of motor, oculomotor and cognitive function in progressive supranuclear palsy. PloS one. 2013;8(9):e74486.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  33. Bense S, Best C, Buchholz HG, Wiener V, Schreckenberger M, Bartenstein P, et al. 18F-fluorodeoxyglucose hypometabolism in cerebellar tonsil and flocculus in downbeat nystagmus. Neuroreport. 2006;17(6):599–603.

    Article  PubMed  Google Scholar 

  34. Kalla R, Glasauer S, Schautzer F, Lehnen N, Buttner U, Strupp M, et al. 4-aminopyridine improves downbeat nystagmus, smooth pursuit, and VOR gain. Neurology. 2004;62(7):1228–9.

    Article  CAS  PubMed  Google Scholar 

  35. Strupp M, Kalla R, Glasauer S, Wagner J, Hufner K, Jahn K, et al. Aminopyridines for the treatment of cerebellar and ocular motor disorders. Progress in brain research. 2008;171:535–41.

    Article  PubMed  Google Scholar 

  36. Zijlstra GA, van Haastregt JC, van Eijk JT, van Rossum E, Stalenhoef PA, Kempen GI. Prevalence and correlates of fear of falling, and associated avoidance of activity in the general population of community-living older people. Age and ageing. 2007;36(3):304–9.

    Article  CAS  PubMed  Google Scholar 

  37. van Haastregt JC, Zijlstra GA, van Rossum E, van Eijk JT, Kempen GI. Feelings of anxiety and symptoms of depression in community-living older persons who avoid activity for fear of falling. The American journal of geriatric psychiatry: official journal of the American Association for Geriatric Psychiatry. 2008;16(3):186–93.

    Article  Google Scholar 

  38. Zwergal A, Linn J, Xiong G, Brandt T, Strupp M, Jahn K. Aging of human supraspinal locomotor and postural control in fMRI. Neurobiology of aging. 2012;33(6):1073–84.

    Article  PubMed  Google Scholar 

  39. Kendrick D, Kumar A, Carpenter H, Zijlstra GA, Skelton DA, Cook JR, et al. Exercise for reducing fear of falling in older people living in the community. The Cochrane database of systematic reviews. 2014;11:Cd009848.

    PubMed  Google Scholar 

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Correspondence to Caroline Heinze.

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Die Autoren erklären, dass sie sich bei der Erstellung des Beitrages von keinen wirtschaftlichen Interessen leiten ließen und dass keine potenziellen Interessenkonflikte vorliegen. Der Verlag erklärt, dass die inhaltliche Qualität des Beitrags von zwei unabhängigen Gutachtern geprüft wurde. Werbung in dieser Zeitschriftenausgabe hat keinen Bezug zur CME-Fortbildung. Der Verlag garantiert, dass die CME-Fortbildung sowie die CME-Fragen frei sind von werblichen Aussagen und keinerlei Produktempfehlungen enthalten. Dies gilt insbesondere für Präparate, die zur Therapie des dargestellten Krankheitsbildes geeignet sind.

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Heinze, C., Schniepp, R. & Jahn, K. Schwindel, Dysbalance, Benommenheit und Gangunsicherheit im Alter. DNP 16, 46–53 (2015). https://doi.org/10.1007/s15202-015-0584-0

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  • DOI: https://doi.org/10.1007/s15202-015-0584-0

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