Health-Related Quality of Life Among People With Bilateral Vestibulopathy With and Without Hearing Loss: A Prospective Study Using Generic and Disease-Specific Instruments

OBJECTIVES: Bilateral vestibulopathy (BVP) is a chronic vestibular disorder which leads to postural imbalance, gait unsteadiness, and movement-induced oscillopsia. Limited data are available on health-related quality of life (HRQoL) in patients with BVP and whether the association with sensorineural hearing loss would further impact these results. The aim of this study was to study HRQoL among patients with BVP using generic and disease-specific instruments in patients with and without concomitant sensorineural hearing loss. METHODS: A prospective study was performed at the Antwerp University Hospital on patients diagnosed with BVP according to the 2017 Bárány Society criteria. The EuroQol-5D-5L (EQ-5D-5L) and Health Utilities Index Mark 3 (HUI-3) were used to assess generic HRQoL. The Dizziness Handicap Index (DHI) and Oscillopsia Severity Questionnaire (OSQ) were used to assess disease-specific HRQoL. To determine the influence of concomitant hearing impairment on HRQoL, the hearing status was tested using the unaided pure-tone averages dB HL (PTA 1, 2, and 4 kHz) and speech perception in noise (SPIN) in the best-aided condition. RESULTS: One hundred and one patients (53 male, 48 female; mean age 60.4 years, range: 18 to 88 years) were included, of which 72 completed all questionnaires. The mean HUI-3 score (0.50; SD ±0.31) indicated severe disability. The mean utility scores for the Dutch EQ-5D-5L (mean 0.73; SD ±0.25) were lower than the mean reference values. The mean DHI score of 37.86 (SD ±25.72) indicated a moderate self-perceived handicap. The mean OSQ score (2.63; SD ±0.91) was lower compared with previous studies, indicating lower symptom severity. Regarding the correlation between hearing impairment and HRQoL, higher SPIN scores were associated with a decrease in HRQoL (p < 0.05) using the HUI-3 and the EQ-5D-5L. However, for the DHI and OSQ, no significant difference was detected for either the unaided pure-tone average (p > 0.05) or the best-aided SPIN (p > 0.05). CONCLUSIONS: HRQoL is significantly reduced in patients with BVP, as evidenced by both generic and disease-specific instruments, with these patients experiencing a range of disability from moderate to severe. Furthermore, difficulties in understanding speech in noise impose an additional burden on HRQoL, a factor that can be identified through the HUI-3 and EQ-5D assessments.