Dizziness, psychological disorders, and cognitive decline.

INTRODUCTION Dizziness is a common disorder, particularly among the elderly population. Aim of this paper is to revise the current concepts surrounding the relationship between dizziness, psychological disorders and cognitive decline. EVIDENCE ACQUISITION PRISMA-compliant systematic review, including observational studies in people with dizziness. Database inception, Medline/Cochrane/Embase/Web of Science/Scopus/NHS evidence, last search 30th October 2019. EVIDENCE SYNTHESIS Overall 22 studies, and 65730 participants were included. 11 studies were cross-sectional, 7 cross-sectional controlled, 2 prospective case-control, 1 retrospective case series, and 1 cohort study. The persistence of vestibular impairment (for 6 months or more) was correlated to the presence of psychological disorders affecting patient's quality of life and causing social anxiety, particularly in some conditions such as Meniere's Disease. Interestingly, vestibular loss has been also correlated to cognitive impairment, with certain vestibular dysfunctions reported to be more prevalent in cognitive impaired individuals. CONCLUSIONS The current literature suggests that there is an association between vestibular function, psychological disorders and cognitive functions. The findings from this review could be useful in informing on the need for a multidimensional diagnostic and rehabilitative programs for patients with dizziness. More studies could explore the role of counselling or behavioral therapy with an aim to reduce the perceived dizziness-related disability.