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DOI 10.37219/2528-8253-2025-6-75

Dieieva YuV, Moshenska OP, Dovhych SV
PRESBYVESTIBULOPATHY: A CONTEMPORARY PERSPECTIVE
ON AGE-RELATED BALANCE DISORDERS
Dieieva Julia V
Bogomolets National Medical University, Kyiv, Ukraine
Head of the department of Otorhinolaryngology
MD, PhD, professor
Email: deyeva@bigmir.net
ORCID ID: https://orcid.org/0000-0003-0552-1254
https://www.scopus.com/authid/detail.uri?authorId=55359076200
Moshenska Olena P
MD, PhD
Assistant of the Department of General Medicine «Akademiya Dobrobut»
E-mail: olena.moshenska@gmail.com
ORCID ID: https://orcid.org/0009-0002-2829-9115
Dovgich Sergey
Bogomolets National Medical University, Kyiv, Ukraine
Associate Professor of the Department of Otorhinolaryngology
PhD
Email: sergeydovgi4@gmail.com
ORCID ID: https://orcid.org/0009-0002-5983-6323

Abstract

Presbyvestibulopathy represents a chronic vestibular syndrome in elderly individuals caused by age-related decline in the function of both peripheral and central components of the vestibular apparatus. This article summarizes data on epidemiology, pathophysiological mechanisms, clinical manifestations, diagnostic criteria, and treatment approaches for this condition. It is shown that the prevalence of vestibular disorders in the elderly constitutes a serious medical and social problem. The presented data indicate that nearly 50% of people over 60 years of age have various manifestations of vestibular dysfunction on objective testing. Studies demonstrate that prevalence increases with age to 85% in individuals over 80 years. Balance disorders in the elderly increase the risk of falls by 5-8 times compared to healthy individuals, leading to fractures, depression, and social isolation. The clinical picture is characterized by feelings of unsteadiness, gait disturbances, and recurrent falls against a background of moderate bilateral vestibular hypofunction. Diagnostic criteria for presbyvestibulopathy developed by the Bárány Society Classification Committee in 2019 are reviewed in detail, which include four mandatory criteria. Age-related degenerative changes in both peripheral and central components of the balance system are analyzed, including reduction in hair cell numbers, statolith degeneration, decreased vestibular ganglion cell populations, cerebellar atrophy, and impaired neuroplasticity. It is emphasized that non-pharmacological interventions form the basis of patient management, among which vestibular rehabilitation demonstrates the highest efficacy in improving balance and reducing fall risk even in elderly individuals. The article emphasizes the importance of early detection of presbyvestibulopathy for timely initiation of rehabilitation measures and fall prevention, which gains particular significance given the projected population aging.

Keywords: vestibular dysfunction, vestibulopathy, stabilography, presbyvestibulopathy, age-related vestibular disorders, dizziness in the elderly, balance disorders, vestibular rehabilitation, bilateral vestibulopathy, population aging, inner ear.

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