Vestibular Disorders May Result in Impaired Cognitive Function

CLINICAL QUESTION

What does current consolidated and condensed evidence indicate about the potential association between vestibular diseases and cognitive impairment?

BOTTOM LINE

Findings indicate that vestibular disorders can result in impairments across various aspects of cognitive functioning, particularly in visuospatial cognition.

BACKGROUND: Vestibular symptoms such as dizziness or vertigo are the most frequent complaints at clinic visits. Such patients usually experience recurrent symptoms, and their daily activities are affected. Some experience anxiety and depression. Patients with vestibular disorders may also suffer from a range of cognitive dysfunctions, but studies exploring this are lacking.

STUDY DESIGN: Systematic review

SETTING: Department of Otorhinolaryngology, Chengdu University of Traditional Chinese Medicine, Chengdu, China

SYNOPSIS: Researchers conducted a systematic keyword search on multiple databases for vestibular symptoms and disorders and cognitive function/dysfunction, and 45 studies were included, most of which targeted middle-aged and older individuals. Vestibular disorders were classified as syndromes, such as vestibular migraines, Ménière’s disease, benign paroxysmal positional vertigo, and unilateral or bilateral chronic vestibular dysfunctions. Across the studies, cognitive function, memory, and executive function were primarily assessed via questionnaires and/or tests. Two epidemiologic studies revealed a significant association between vestibular decline and cognitive dysfunction. Four studies compared cognitive function between patients with chronic unilateral and bilateral vestibular dysfunction; all four found some degree of cognitive impairment in different dimensions, particularly in visuospatial memory. Another five studies found associations between chronic vestibular function (not separated into uni- and bilateral) and visuospatial ability, short-term memory, and executive function. Authors emphasize in their discussion of previous findings that spatial cognitive deficits associated with vestibular dysfunction are attributed to abnormalities in the structural functioning of, and structural changes in, the hippocampus, and note the crucial role of the hippocampus in the vestibular neural network. Study limitations include the variance in approaches among the reviewed articles.

CITATION: Li J, et al. Association of vestibular disorders and cognitive function: a systematic review. Laryngoscope. 2024;134:4858-4872. doi: 10.1002/lary.31646.