Calcium is vital for the functioning of the inner ear hair cells as well as for the neurotransmitter release that triggers the generation of a nerve impulse. A reduction in calcium level could therefore impair the peripheric vestibular functioning. However, the outcome of balance assessment has rarely been explored in cases with osteopenia and osteoporosis, the medical conditions associated with reduction in calcium levels. The present study aimed to investigate the impact of osteopenia and osteoporosis on the outcomes of behavioural and objective vestibular assessment tests. The study included 12 individuals each in the healthy control group and osteopenia group, and 11 individuals were included in the osteoporosis group. The groups were divided based on the findings of bone mineral density. All the participants underwent behavioural tests (Fukuda stepping, tandem gait and subjective visual vertical) and objective assessment using cervical and ocular vestibular evoked myogenic potentials. A significantly higher proportion of the individuals in the two clinical groups' demonstrated abnormal results on the behavioural balance assessment tests (p<0.05) than the control group. However, there was no significant difference in latencies or amplitude of cervical vestibular evoked myogenic potential and oVEMP between the groups. The proportion of individuals with absence of ocular vestibular evoked myogenic potential was significantly higher in the osteoporosis group than the other two groups (p<0.05). The findings of the present study confirm the presence of balance-related deficits in individuals with osteopenia and osteoporosis. Hence the clinical evaluations should include balance assessment as a mandatory aspect of the overall audiological assessment of individuals with osteopenia and osteoporosis.

Purpose: An increase in the 1000/500 Hz frequency amplitude ratio (FAR) of the cervical and ocular vestibular evoked myogenic potentials (cVEMP and oVEMP, respectively) may serve as a potential biomarker for diagnosing Meniere's disease (MD). However, the aging process can also result in an increased FAR for VEMPs. In older patients, distinguishing whether changes in VEMP FAR are due to MD or aging processes becomes difficult. We aimed to investigate the effects of age on VEMP FARs and establish a FAR-normative range for different age groups. Method: cVEMP and oVEMP were recorded from a total of 106 participants grouped as young, middle-aged, and older adults using air-conducted tone bursts at 500, 750, and 1000 Hz at 125 dB pSPL. The FAR was calculated for the cVEMP and oVEMP for the following frequencies: FAR1 = 1000/500, FAR2 = 1000/750, and FAR3 = 750/500. Results: A significant age-related effect was observed on the cVEMP FAR. Although the oVEMP FAR showed an increasing trend with age, it was not statistically significant. Age-based normative FAR values are provided. Conclusions: Drawing from the normative FAR from this study, there is evidence that the existing MD diagnostic criteria would misidentify a considerable number of older adults. Therefore, to reduce false positives, we recommend a more stringent cVEMP and oVEMP FAR criterion in older adults.

Background To achieve balance, persons with blindness (PWB) use proprioceptive and vestibular cues rather than the visual system; however, PWB are equally susceptible to acquire vestibular disorders. Reliable assessments of the vestibular system in PWB are essential to determine the presence or absence of vestibular disorders. Purpose The saccular and the utricular functioning can be assessed using cervical vestibular-evoked myogenic potential and ocular vestibular-evoked myogenic potential, respectively. Evaluation of the functional integrity of the semicircular canals requires an assessment of the vestibular ocular reflex; however, this can be challenging in PWB. Video head impulse test (vHIT) assesses the vestibular ocular reflex (VOR) elicited against the natural high-frequency head movement in the planes of all six semicircular canals. This study aimed to explore the feasibility and outcomes of administering vHIT in PWB. Research Design Standard (static) groups comparison. Study Sample Nineteen young PWB and 23 age-matched adults with “normal” vision (control group) were included in the study. Data Collection and Analyses PWB underwent vHIT once, while the control group was tested in three conditions; condition 1 was used to simulate blindness for the control group, where vHIT was done in a pitch-dark room without prior instructions; condition 2 included vHIT testing in daylight, without a fixed visual target and any instructions; and condition 3 involved vHIT in daylight in the presence of a set visual target and with standard instructions to maintain visual focus on the visual target. Results The VOR gain was abnormal in the PWB group for all the canals. Among the PWB, the lateral canals (mean = 0.63) had the best VOR gain, followed by the anterior canals (mean = 0.53) and the posterior canals (mean = 0.31). In the control group, the VOR gain was significantly reduced in condition 1. There was no significant difference between the VOR gain in the PWB group and the control group in condition 1 for the lateral and the anterior canals. A higher proportion of participants in the PWB group had the presence of refixation saccades. Conclusion VOR is significantly reduced in PWB but not completely absent. There may be a need to develop normative data for blind individuals to decide whether or not a person with blindness has a vestibular dysfunction, specifically a VOR deficit.