Which factors influence the deterioration in vestibular function? A nationwide, population-based study with video-head impulse test

Objectives We aimed to investigate the prevalence and age-related changes in vestibular function within the general population using survey data from the Korean National Health and Nutrition Examination Survey (KNHANES) and examine the potential factors influencing it. Methods We analyzed retrospective data from 1270 participants from the 2021 KNHANES who completed both the video head impulse test and audiometric evaluations. Participants with vestibulo-ocular reflex (VOR) gains <0.8 and >1.2 were excluded to minimize the impact of possible testing errors and prior impaired vestibular function. We assessed the prevalence and age-related changes in vestibular function and analyzed potential influencing factors using logistic regression analysis. Results The VOR gain decreased with age; however, statistical significance was not achieved (coefficient −0.0003, p = 0.281). The presence of corrective saccades significantly increased with age ( p < 0.001), with those in their 70s being 3.98 times more likely to exhibit corrective saccades than those in their 40s. The overall prevalence was 17.08%. Subjects with corrective saccades exhibit lower VOR gain than those without it ( p < 0.001). Age, sex, hypertriglyceridemia, and hearing levels at 4000 Hz were significantly associated with the presence of corrective saccades. Conclusion Vestibular function declined with age, influenced significantly by sex, hypertriglyceridemia, and hearing level at 4000 Hz. The increased prevalence of corrective saccades among older adults underscores the importance of early detection and intervention. Understanding age-related changes in vestibular function can facilitate appropriate management strategies and countermeasures at the personal and societal healthcare level.