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HeadLines - To Make Fall Statistics Fall

Summer 2010

To Make Fall Statistics Fall

Date: 06/14/2010


Yuri Agrawal
“Falls are a large public health problem,” says Yuri Agrawal. “Vestibular dysfunction accounts for a pretty high portion of that, and some people don’t even realize they have it.”
Keith Weller

A loss of balance can lead to a fall. And a fall, particularly in the elderly, can have catastrophic consequences.

For Yuri Agrawal, the question is how often those falls are the result of vestibular dysfunction and whether they can be prevented.

Without thinking much about it, humans rely on three different systems to keep themselves upright. There’s sight, which allows people to know up and down, left and right. Next comes touch, which tells your feet what kind of surface they’re on and which direction they’re going. Then there’s the vestibular system, three tiny organs in the ear that give people a sense of where they are relative to gravity. Without properly functioning vestibular organs, a person may as well be walking across a trampoline coated in baby oil.

During a recent study of national data on falls, Agrawal—a vestibular specialist in the Johns Hopkins Department of Otolaryngology–Head and Neck Surgery—and her colleagues found that between 6 million and 9 million adults have some form of balance disorder. Yet standard assessments to determine a patient’s risk of falling typically ignore vestibular dysfunction.

Among the most vulnerable are people 80 and older, whose risk of vestibular dysfunction is 85 percent. An estimated 35 percent of adults over 40 also face some level of the problem.

One of the difficulties in diagnosing vestibular disorders is that the primary symptom—dizziness—can also be caused by many other conditions, such as heart failure, poor nutrition or low blood sugar. Consequently, people often go unaware of their own balance issues until they’ve already fallen. “Part of our efforts to reduce fall risk involves understanding the factors behind it,” Agrawal explains. “We’ve found that vestibular dysfunction is actually much more prevalent than we anticipated.”

Agrawal and her colleagues hope to incorporate this knowledge into assessments of fall risk and continuing research on vestibular disorders and treatments. “There’s an opportunity here to reduce falls,” Agrawal says. “People with vestibular dysfunction face a 12 times higher risk of falling. It is likely that many falls are being caused by this problem.”

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