Abstract
OBJECTIVE: The objective of this study is to investigate the relationship between symptom duration of vestibular-related dizziness/vertigo and cognitive function in elderly patients, and to establish clinical guidance for assessing and intervening in vestibular-related cognitive impairments. METHODS: This study included 100 elderly patients with vestibular dysfunction presenting dizziness, vertigo, or balance disorders, categorized into short-duration (n = 64) and long-duration (n = 36) groups based on symptom duration. A control group of 21 healthy elderly individuals was included. Cognitive assessments comprised P300 event-related potentials (latency/amplitude) and Montreal Cognitive Assessment (MoCA) with domain-specific analysis. RESULTS: Significant between-group differences in P300 latency were observed (control vs short-duration vs long-duration: p < 0.001), whereas amplitude showed no difference (p = 0.817). MoCA total scores differed significantly across groups (p = 0.001), although abnormality rates were comparable (p = 0.093). Domain analysis revealed significant differences in visuospatial (p < 0.001) and abstract abilities (p = 0.005). Symptom duration correlated with: MoCA total (R (2) = 0.113), visuospatial ability (R (2) = 0.181), attention (R (2) = 0.068), and orientation (R (2) = 0.157). P300 latency correlated with: MoCA total (R (2) = 0.141), visuospatial ability (R (2) = 0.090), delayed recall (R (2) = 0.112), and orientation (R (2) = 0.082). CONCLUSION: Prolonged vestibular-related dizziness/vertigo in elderly patients is associated with cognitive deficits, particularly in visuospatial and executive functions. P300 latency demonstrates greater sensitivity than both P300 amplitude and MoCA screening, suggesting that combined electrophysiological and neuropsychological assessment enhances early detection of vestibular-related cognitive impairment. HIGHLIGHTS: Long-duration vestibular-related dizziness or balance disorders are associated with a higher risk of cognitive impairment in elderly patients.Among early assessment tools, P300 latency proves more sensitive than both P300 amplitude and the Montreal Cognitive Assessment (MoCA) questionnaire.A combined evaluation using P300 latency and MoCA provides a more effective measure of how dizziness affects cognitive function in this population.