Relationship between vestibular dysfunction and dementia in elderly patients: Peripheral vertigo or central vertigo

Background Recent research suggests an association between vestibular impairment and dementia. Mild cognitive impairment (MCI) and dementia patients are associated with increased rate of vestibular loss. The vestibular system consists of the peripheral vestibular organs and the associated extensive vestibular cortical pathway. We investigate whether vertigo (peripheral vertigo or central vertigo) is correlated with an increased risk of dementia and clinical relevance of vertigo types to dementia. Method From August 2019 to January 2020, 300 patients, aged ≥ 50 years and vertigo symptom were retrospectively enrolled. Multivariate a Multivariate analysis was performed for vertigo types that showed a significant difference between dementia and non‐dementia groups. First, we reviewed vertigo with previous diagnosed 177 dementia and 123 healthy controls, and the differences in vertigo types between these groups were examined. Second, the patients with vertigo were classified into 2 groups: peripheral (Acute vestibular neuritis, Meniere's disease, Benign paroxysmal positional vertigo, Autonomic related vertigo, and so on) or central (Stroke, Vertiginous migraine and Epilepsy vertigo) types. Third, dementia groups included AD, VaD and Mixed types. Finally, this study evaluated risk factors for vertigo in cognitive impairment patients. Result Among 177 dementia patients with a mean age of 75.30 years, 56 (31.63%) developed vertigo. The frequency of vertigo types (peripheral vertigo or central vertigo) was different in dementia with vertiginous patients compared to non dementia groups {peripheral: central 55.35% vs 44.64%; 81.30% vs 18.69}. In this study, total 56 vertigo patients were divided into two groups based on peripheral type (n = 31) or central type (n = 25). There was no significant difference in vertigo classification between peripheral and central according to dementia subtype. On the other hand, 121 individuals with dementia were not found symptom of vertigo. Among, 123 non dementia patients with vertigo, there were 100 of peripheral vertigo (81.30%) and 23 of central vertigo (18.69%). Conclusion The classification of vertigo is different depending on dementia or not. The proportion of central vertigo has a tendency to increase with dementia groups. The findings of our study may provide direction for potentially useful diagnostic tests and vestibular‐targeted therapy such problem in dementia patients.