목적: Fall and vestibular dysfunction are increased with age. Degenerative changes including osteoporosis may be associated with these. However, there was no study analyzing the contributions of altered bone metabolism to vestibular dysfunction. This study was conducted to clarify if the parameters related to bone metabolism are associated with vestibular dysfunction, independently with other risk factors. If this is true, the correction of pathologic change in bone metabolism may lessen the incidence of vestibular fall or dizziness. 방법:The participants with 50 years were collected from the Korean National Health and Nutrition Examination Survey(KNHANES) 2009 - 2010. They were classified according to fall and vestibular fall proved by modified Romberg test. Bone mineral density(BMD), serum level of vitamin D(VitD), parathyroid hormone(PTH) and alkaline phosphatase(ALP) were measured. Female were surveyed whether they experienced the estrogen replacement therapy(HRT). The relations between vestibular problem or fall and BMD/ VitD/ PTH/ ALP/ HRT were analyzed using simple and multiple logistic regression analysis with complex sampling, adjusted for other risk factors. 결과:The BMD, VitD, PTH, ALP were related with vestibular problem in univariable analsysis. The vitamin D (p = 0.002, Estimated value (EV) =1.045) and ALP (p = 0.008, EV=0.998) were related with vestibular problem in multivariable analysis. According to the subgroup analysis on gender, male showed relation between vestibular problem and serum vitamin D/ ALP. Interestingly, HRT was related with vestibular problem in female group (p = 0.05, OR = 0.502). 결론:Degenerative changes of bone metabolism associated with vestibular problem in elderly. After adjusted for age associated factors, there were unique correlations serum vitamin D and ALP with vestibular problem. Postmenopausal women replaced estrogen were related with less vestibular problem.