Benign Paroxysmal Positional Vertigo (BPPV) in Older Patients
Status:
Not yet recruiting
Trial end date:
2022-11-01
Target enrollment:
Participant gender:
Summary
Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of vertigo in older
adults (Parham & Kuchel, 2016). It is caused by dislodged otoconia, which fall from the
utricular macula into the semicircular canals causing them to move through the canals with
the effect of gravity (Parnes et al., 2003). Treatment of BPPV is primarily with Canalith
Repositioning Procedure (CRP) with more than 80% success rates. However, BPPV can recur in
10-20% of the time and in some long-term follow-up studies reporting up to 50% recurrence
rates (Fife et al., 2008). Despite BPPV being considered a benign self-limiting condition, it
has far reaching physical and psychosocial consequences for the geriatric population such as
injuries from falls precipitated by vertiginous attacks and fear of unexpected vertigo
leading to restriction of daily activities and functional decline (Balatsouras et al., 2018;
Kao et al., 2009). Studies have shown that the 1-year prevalence of individuals with BPPV
attacks rises steeply with age, with the cumulative (lifetime) incidence of BPPV reaching
almost 10% by the age of 80 (Parham & Kuchel, 2016). Aging has also been shown to be a
primary risk factor for idiopathic BPPV, with events such as prolonged bed rest postulated
for being a trigger for BPPV (Parham & Kuchel, 2016). BPPV is also noted to be underreported
in the elderly mainly due to the different manifestations such as less rotatory vertigo and
more nonspecific dizziness and instability, with consecutive examinations in geriatric
population revealing that 9% of elderly have unrecognized BPPV (Oghalai et al., 2000). Given
the increased prevalence and severe implications of BPPV on there is a strong impetus for
this study to lower the recurrence of BPPV in this vulnerable older population.