Biomedical subjects

J A Enrietto

Publications and source records attributed to J A Enrietto.

4 recordsLinked to original sources

PubMed1998

Balance disorders in older persons: quantification with posturography.

We measured sway velocity using static and dynamic posturography in a group of young normal subjects and two groups of subjects older than 75 years; one older group considered their balance normal for their age, and the other reported imbalance. The latter group consisted of patients with documented peripheral and central vestibular disorders and patients with dizziness and imbalance of unknown cause. The velocity of sway was higher in older subjects than in younger subjects and in older subjects who reported imbalance than in age-matched controls. The difference was greater with dynamic posturography than with static posturography, but the posturography data provided little information about the cause of the imbalance and did not correlate with the frequency of reported falls.

Accidental Falls↗

PubMed1998

A prospective study of posturography in normal older people.

OBJECTIVE: To follow posturographic measurements over time in a group of normal older subjects to see if sway increases with aging and if sway is greater in those with deteriorating balance and falls. SUBJECTS: Seventy-two community-dwelling older people (age range 79-91 years), who initially had normal neurological evaluations, were followed with three yearly follow-up examinations. MEASUREMENTS: Amplitude and velocity of sway on static and dynamic posturography, Tinetti gait and balance score, reports of falls. RESULTS: Velocity of sway on dynamic tests increased significantly during the 3 years of follow-up. The percentage increase in sway was about the same in the anterior-posterior and medial-lateral directions and with eyes open and eyes closed. Subjects with low Tinetti scores had higher sway amplitude and velocity, particularly on dynamic tests, but no measure of sway was significantly different in those who reported falls compared with those who did not report falls. CONCLUSIONS: Sway increases in normal subjects over time, and sway is greater in older subjects with deteriorating balance compared with those with normal balance. Sway was not greater in those who fell compared with those who did not fall, probably because falls are highly dependent on individual behavior.

Accidental Falls↗

PubMed1998

Disequilibrium in older people: a prospective study.

OBJECTIVE: To identify the clinical and neuroimaging features in older people with disequilibrium of unknown cause. BACKGROUND: Many older people show a deterioration of balance without an identifiable cause. Whether the disequilibrium is a normal aging phenomenon, the result of yet unidentified neuropathology, or a combination of the two is unknown. METHODS: Twenty-nine patients who complained of disequilibrium (ages 75 to 92) and 29 age- and sex-matched control subjects completed five yearly examinations including history and semiquantitative neurologic examination, activities of daily living, visual acuity, mini-mental status, bedside gait and balance score (Tinetti), Purdue pegboard, and vestibular function testing. Concerns about falling and number of falls were quantified. Subcortical white matter lesions (WML) and frontal atrophy (FA) were graded (blindly), and the ventricular-brain ratio (VBR) was measured from MRIs of the brain. RESULTS: On entry, patients differed from control subjects only in measures of balance, concerns about falling, and falls. Over the 5 years, patients were four times more likely to fall than control subjects. The number of falls was highly correlated with measures of balance (p < 0.001). The VBR as well as the frequency of WML and FA were all significantly (p < 0.001) greater in patients than in control subjects. CONCLUSION: Disequilibrium of unknown cause in older people is associated with frequent falls, concerns about falling, brain atrophy, and WML on MRI. Some cases are probably caused by small-vessel ischemic disease.

Accidental Falls↗

PubMedDate not supplied

Aging effects on auditory and vestibular responses: a longitudinal study.

PURPOSE: To identify age-related changes in the auditory and vestibular systems in normal older subjects followed serially over time. METHODS: Pure tone hearing levels, speech reception threshold, speech discrimination scores, and vestibulo-ocular responses were measured in 57 normal older subjects (mean age, 82) on 5 yearly examinations. RESULTS: There was a significant (P < .001) increase in pure tone threshold averages (about 1 dB per year) and speech reception threshold averages (about 2 dB per year), and a significant (P < .001) decrease in discrimination scores (about 2% per year) over the 5 years of follow-up. There was a significant (P < .05) amplitude-dependent decrease in gain and increase in phase lead of the vestibulo-ocular reflex and a significant (P < .01) decrease in gain of visual-vestibular responses at low frequency sinusoidal stimulation over the 5 examinations. Years 1 to 5 differences in individual subjects were significantly (P < .01) correlated across auditory and vestibular tests, but not between auditory and vestibular tests (P > .01). CONCLUSION: This is the first longitudinal study to show age-related decreases in auditory and vestibular responses in normal older subjects. Because the age-related changes in the auditory system were not correlated with age-related changes in the vestibular system, the 2 systems may age at different rates in the same individual. These changes likely result from degeneration in both peripheral and central structures, although age-related changes in the central nervous system probably are more important from a functional point of view.

Aged↗