Grant: Catalyst Grant: Pilot Projects in Aging - Biological & Clinical Aspects of Aging

Evidence suggests that diabetes mellitus (DM) may adversely impact inner ear balance contol system (vestibular system) that is critical for maintaining body's balance and orientation during various activities. The first goal of this study is to understand whether in older diabetic patients deficits in vestibular system function can explain higher prevalence of balance and mobility impairments and falls. The second goal is to examine whether status of vestibular system function is related to the blood sugar control (glycemic control) in diabetics. Seventy-two older persons (age 65 and over) will be recruited, 24 into each of three groups (DM with peripheral neuropathy, DM without peripheral neuropathy and healthy controls). Vestibular system functions will be evaluated by caloric testing, subjective visual vertical, dynamic visual acuity and computerized posturography. Balance and functional mobility will be measured using the FICSIT-4 balance test and the modified timed up and go test, respectively. The number of falls in the previous year will be recorded. A1c blood test will represent glycemic control. We hypothesize that compared to age-matched healthy older persons, diabetic elderly will demonstrate significantly worse vestibular functions even in the absence of overt diabetic peripheral neuropathy and the impact of diabetes on vestibular functions will significantly contribute to poorer balance and functional mobility and falls. Further, there will be significant associations between vestibular functions and glycemic control. The balance and mobility impairments following vestibular deficits are amenable to appropriate rehabilitation interventions. Therefore, findings of this study will be useful in developing a targeted physical rehabilitation program for this population. Using the results of this study a large multidisciplinary intervention study will be undertaken that will address functional mobility and disability in diabetic elderly in southern Ontario