The development of the cognitive vestibular function scale in the elderly complaints of imbalance: a study on validity and reliability

Ozkul, Aysenur; Konukseven, Ozlem

doi:10.1016/j.bjorl.2023.101282

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Brazilian Journal of Otorhinolaryngology

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Sumário

Original article • Braz. j. otorhinolaryngol. 89 (4) • 2023 • https://doi.org/10.1016/j.bjorl.2023.101282 copy

The development of the cognitive vestibular function scale in the elderly complaints of imbalance: a study on validity and reliability

Authorship SCIMAGO INSTITUTIONS RANKINGS

Highlights

Clinical and laboratory studies show the relationship of vestibular inputs to various high functions.
Cognitive Vestibular Function Scale is developed to detect cognitive problems associated with vertigo/imbalance.
The basic component analysis is used to evaluate the validity of the scale Cronbach alpha coefficient for its reliability.

Abstract

Objectives

With a valid and reliable scale, it will make an important contribution to the assessment of cognitive functions such as spatial, spatial-visual, and memory functions, and raise awareness of older people with balance disorders. The purpose of this study is to develop a scale to assess vestibular and cognitive functions in the geriatric population with vestibular disorders and to evaluate its validity and reliability.

Methods

The study involved 75 individuals aged 60 years and older who complained of imbalance. In the first phase, scale items on balance, emotional, spatial, spatial-visual, and memory were created using the literature. The item analysis was completed by a pilot application, and 25 scale items were determined for the main application. The item analysis and validity and reliability analyzes were completed, and the scale was given its final form. For the statistical analysis of the data, a principal component analysis was performed for the validity analysis. The Cronbach alpha coefficient was used for the reliability analysis. Descriptive statistics were compiled on the participants' scale scores.

Results

The Cronbach's alpha value of the scale was found to be highly reliable at 0.86. Statistically significant values were found between the age variable and the spatial subscales, the spatial-visual subscales, and the Cognitive Vestibular Function Scale with a small positive effect (respectively: r = 0.264; p = 0.022; r = 0.237; p = 0.041; r = 0.231; p = 0.046). The results indicate that the Cognitive Vestibular Function Scale is a valid and reliable measurement tool at a good level in elderly people aged 60 years and older.

Conclusion

Cognitive Vestibular Function Scale; was developed to detect cognitive problems related to dizziness/balance. As a result, a preliminary study was conducted to investigate a rapid, easy-to-use, and reliable clinical scale to assess cognitive function in people with balance disorders.

Level II Randomized trials Prospective comparative study.

Keywords
Scale; Spatial; Cognition; Cognitive; Dizziness

No. of items	Cronbach's alpha	Cronbach's alpha if item deleted
I. 1 (V)	0.650	0.858
I. 2 (V)	0.635	0.855
I. 3 (V)	0.645	0.856
I. 4 (V)	0.644	0.855
I. 5 (V)	0.622	0.851
I. 6 (V)	0.646	0.857
I. 7 (V)	0.655	0.864
I. 8 (E)	0.737	-
I. 9 (E)	0.714	-
I. 10 (E)	0.716	-
I. 11 (E)	0.720	-
I. 12 (E)	0.732	-
I. 13 (SM)	0.694	0.882
I. 14 (SM)	0.649	0.857
I. 15 (SM)	0.658	0.862
I. 16 (SM)	0.668	0.866
I. 17 (SM)	0.645	0.859
I. 18 (SVM)	0.644	0.858
I. 19 (SVM)	0.656	0.861
I. 20 (SVM)	0.648	0.858
I. 21 (SVM)	0.659	0.861
I. 22 (TM)	0.653	0.860
I. 23 (TM)	0.650	0.863
I. 24 (TM)	0.680	0.875
I. 25 (TM)	0.639	0.857
Total (CVFS)	0.678	0.867

Kaiser-Meyer-Olkin Sample Fit Measure		0.742
Bartlett Test of Sphericity	Approx. Chi-Square	1225.884
	df	300
	Sig.	<0.001

Scales	Percentage of variance explained (%)	Cronbach alpha	Items
Vestibular	59.696	0.879	7
Emotional	40.967	0.435	5
Spatial Memory	43.528	0.619	5
Spatial-Visual Memory	48.362	0.582	4
Temporal Memory	50.189	0.628	4
CVFS	74.556	0.879	20

n = 75		V	SM	SVM	TM	CVFS
Age	r _s	0.23	0.264^a a Correlation is significant at the 0.05 level (2-tailed).	0.237^a a Correlation is significant at the 0.05 level (2-tailed).	0.114	0.231^a a Correlation is significant at the 0.05 level (2-tailed).
Age	p	0.05	0.022	0.041	0.329	0.046
V	r _s		0.399^b b Correlation is significant at the 0.01 level (2-tailed).	0.648^b b Correlation is significant at the 0.01 level (2-tailed).	0.281^a a Correlation is significant at the 0.05 level (2-tailed).	0.769^b b Correlation is significant at the 0.01 level (2-tailed).
V	p		<0.001	<0.001	0.014	<0.001
SM	r _s			0.530^b b Correlation is significant at the 0.01 level (2-tailed).	0.427^b b Correlation is significant at the 0.01 level (2-tailed).	0.704^b b Correlation is significant at the 0.01 level (2-tailed).
SM	p			0.001	0.001	0.001
SVM	r _s				0.629^b b Correlation is significant at the 0.01 level (2-tailed).	0.813^b b Correlation is significant at the 0.01 level (2-tailed).
SVM	p				<0.001	<0.001
TB	r _s					0.683^b b Correlation is significant at the 0.01 level (2-tailed).
TB	p					<0.001

	Mean ± SD	Min.	Max.	n
Vestibular	16.35 ± 6.622	7	32	75
Spatial memory	10.87 ± 3.504	5	21	75
Spatial-visual memory	7.67 ± 2.663	5	16	75
Temporal memory	10.36 ± 3.447	4	19	75
CVFS	45.24 ± 12.845	4	86	75

Tick your involvement in the following statements according to the scoring system alongside. Please leave nothing unmarked.
	Always	Often	Sometimes	Rarely	Never
Vestibular
1 I suffer from vertigo (in the form of environmental rotation).
2 When I stand still, I feel an imbalance (trembling/swaying).
3 When I left my head or tilt down, I feel imbalance/dizziness.
4 When I walk, I feel like I am going left or right.
5 I feel unbalanced/dizzy when I walk.
6 I suffer from imbalance/dizziness in the presence of fluorescent light/bright lighting.
7 I walk comfortably in the dark.*
Total Score for Each Column
Total Points
Spatial Memory
8 I easily estimate the distance between my location and an object/person.*
9 When I close my eyes, I find it difficult to describe a familiar environment.
10 When I close my eyes, I find it difficult to tell you what is new in my surroundings.
11 I find it hard to find my car in the big car parks.
12 When I wake up at night, I have difficulty finding the kitchen/toilet in the dark.
Total Score for Each Column
Total Points
Spatial-Visual Memory
13 I have difficulty remembering where I put certain items (controllers, phones, etc.).
14 Magazines or newspaper pages confuse me when I read.
15 I have difficulty recognizing familiar places (grocery shops, bakeries, etc.).
16 I find it difficult to get to know relatives or friends.
Total Score for Each Column
Total Points
Temporal Memory
17 I find it difficult to remember my appointments, e.g., at the doctor's, at friends', etc.
18 I forget birthdays and special occasions.
19 I know what day of the week I am.*
20 I am distracted/unaware during the day.
Total Score for Each Column
Total Points

Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Sede da Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico Facial, Av. Indianópolia, 1287, 04063-002 São Paulo/SP Brasil, Tel.: (0xx11) 5053-7500, Fax: (0xx11) 5053-7512 - São Paulo - SP - Brazil
E-mail: revista@aborlccf.org.br

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[1] ⁎ Corresponding author. E-mail: aozkul@stu.aydin.edu.tr (A. Ozkul).