Multiple clinical studies have demonstrated that vestibular dysfunctions, such as benign paroxysmal positional vertigo (BPPV) and Meniere's disease (MD), are associated with osteoporosis or osteopenia in adults. Animal studies have also indicated that selective ablation of peripheral vestibular organs leads to reduced bone mineral density in mice, potentially through effects on the sympathetic nervous system....
Audiologists and vestibular clinicians should consider that patients presenting with BPPV or Menière's disease may have an elevated risk of osteoporosis; while this review strengthens the association, referral pathways for bone density screening should be discussed with referring physicians rather than actioned unilaterally.
A confirmed link between vestibular disorders and osteoporosis would justify integrated screening protocols across audiology and rheumatology/primary care, potentially reducing fracture risk in a population already vulnerable to falls.
- 01Systematic review and meta-analysis provide the highest level of epidemiological evidence for a vestibular–osteoporosis association.
- 02Both BPPV and Menière's disease are examined, allowing comparison across vestibular disorder subtypes.
- 03Osteoporosis and vestibular disorders share calcium metabolism pathways, providing a plausible biological mechanism.
- 04A positive association would support multidisciplinary screening and co-management strategies.
- 05Findings are directly relevant to falls-risk management in older adults attending vestibular clinics.
There is a statistically significant association between BPPV and osteoporosis in adults.
studysupportedThere is a statistically significant association between Menière's disease and osteoporosis in adults.
studypartially supportedVestibular dysfunction and osteoporosis share a common pathophysiological mechanism involving calcium metabolism.
studyunclear- PMID
- 42260120
- DOI
- 10.1007/s00198-026-08094-3.
- Journal
- Osteoporosis International
- Publication type
- meta_analysis
- Evidence level
- 1a
- Population
- Adults with vestibular dysfunctions (BPPV and Menière's disease) compared to controls across multiple clinical studies
- Intervention
- Presence of vestibular dysfunction (BPPV or Menière's disease)
- Comparator
- Adults without vestibular dysfunction
Primary outcomes
Prevalence/odds of osteoporosis in patients with vestibular dysfunction; Association strength (odds ratio or relative risk) between vestibular disorders and osteoporosis