Vestibular vertigo and comorbid cognitive and psychiatric impairment: the 2008 National Health Interview Survey

萧条(经济学) 精神科 焦虑 共病 惊恐障碍 优势比 广场恐怖症 医学 眩晕 心理学 听力学 内科学 外科 经济 宏观经济学
作者
Robin T. Bigelow,Yevgeniy R. Semenov,Sascha du,Howard J. Hoffman,Yuri Agrawal
出处
期刊:Journal of Neurology, Neurosurgery, and Psychiatry [BMJ]
卷期号:87 (4): 367-372 被引量:140
标识
DOI:10.1136/jnnp-2015-310319
摘要

Background/aims

Patients with vestibular disease have been observed to have concomitant cognitive and psychiatric dysfunction. We evaluated the association between vestibular vertigo, cognitive impairment and psychiatric conditions in a nationally representative sample of US adults.

Methods

We performed a cross-sectional analysis using the 2008 National Health Interview Survey (NHIS), which included a Balance and Dizziness Supplement, and questions about cognitive function and psychiatric comorbidity. We evaluated the association between vestibular vertigo, cognitive impairment (memory loss, difficulty concentrating, confusion) and psychiatric diagnoses (depression, anxiety and panic disorder).

Results

We observed an 8.4% 1-year prevalence of vestibular vertigo among US adults. In adjusted analyses, individuals with vestibular vertigo had an eightfold increased odds of 'serious difficulty concentrating or remembering' (OR 8.3, 95% CI 4.8 to 14.6) and a fourfold increased odds of activity limitation due to difficulty remembering or confusion (OR 3.9, 95% CI 3.1 to 5.0) relative to the rest of the US adults. Individuals with vestibular vertigo also had a threefold increased odds of depression (OR 3.4, 95% CI 2.9 to 3.9), anxiety (OR 3.2, 95% CI 2.8 to 3.6) and panic disorder (OR 3.4, 95% CI 2.9 to 4.0).

Conclusions

Our findings indicate that vestibular impairment is associated with increased risk of cognitive and psychiatric comorbidity. The vestibular system is anatomically connected with widespread regions of the cerebral cortex, hippocampus and amygdala. Loss of vestibular inputs may lead to impairment of these cognitive and affective circuits. Further longitudinal research is required to determine if these associations are causal.
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