Silent neurovestibular frailty: a conceptual model integrating vestibular dysfunction, dual-task mobility and cognitive load as candidate contributors to falls, delirium and functional decline in older adults

Falls, delirium and functional decline are commonly treated as distinct geriatric outcomes despite sharing vulnerabilities in sensory integration, gait regulation, attention and physiological reserve. We propose silent neurovestibular frailty as a conceptual model describing a latent ageing phenotype in which vestibular dysfunction, dual-task gait deterioration and sensitivity to cognitive load interact before overt...

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No actionable change — this is a conceptual model paper without clinical trial data; it may prompt clinicians to consider routine vestibular screening in older adults at risk for falls or delirium, but evidence to support changing practice is not yet available.

Framing vestibular dysfunction as a 'silent' contributor to frailty syndromes in older adults could shift how audiologists and geriatricians collaborate on fall-prevention and cognitive-decline screening programmes.

1. 01Conceptual model paper — no primary data collected; no patient participants.
2. 02Proposes three interacting contributors to geriatric decline: silent vestibular dysfunction, dual-task mobility deficits, and cognitive load.
3. 03Targets high-stakes outcomes: falls, delirium, and functional decline in older adults.
4. 04Published in Frontiers in Aging Neuroscience.
5. 05Intended to generate testable hypotheses for future empirical research, not to guide immediate clinical decisions.

PMID

42688266

DOI

10.3389/fnagi.2026.1879751.

Journal

Frontiers in Aging Neuroscience

Publication type

review

Evidence level

5

Population

Older adults (conceptual model; no empirical patient population studied)

Intervention

Conceptual integration of vestibular dysfunction, dual-task mobility, and cognitive load