Presbyastasis: from diagnosis to management

Currently, the elderly population (>65 years old) is in very growth. In fact, in Italy old age index (number of elderly per 100 persons under the age of 14 years) is estimated to be 157,7 and is projected to increase to 257,9 in the year 20651,2. The increase of the elderly population determines the increase of the age-dependent diseases including also impairment of the vestibular function, this problem is defined "presbiastasia". Patient suffering from this condition exhibit disturbances of static and dynamic postural control with far less frequent cases of relapsing objective rotatory vertigo. Occasionally, they also report a feeling of insecurity in new or unknown environments, increasing the risk of falls. These balance disorders significantly affect patients’ private and social life, as they interfere with a large number of daily activities, as transfer into bed, ambulation, car transfers, eating, using of telephone. The number of patients with this disease is expected to increase with the rise in the number of elderly population and this has important implications on the national health system's resources. Thus, the rehabilitation of these balance disorders presents serious difficulties. This explains the great number of techniques, with or without the use of equipment, which have so far been proposed. Some authors suggested to apply actual protocols, more or less modifiable according to patient characteristics; others recommended individual exercises or special equipment-aided techniques. In these cases, vestibular rehabilitation allows to stimulate the equilibrium system by preventing and slowing down the effects of aging, through the use of "adaptive, substitutive and custom" strategies.