Standing Balance Among Older Adults With and Without Cognitive Impairment

Research Objectives: Patients with cognitive impairment, particularly Alzheimer's disease, differ from normal adults in their standing balance. However, it has not been clear whether the onset of the difference starts at the very early stage of cognitive impairment. This study aims to assess standing balance among older adults with and without mild cognitive impairment (MCI) and mild dementia of the Alzheimer type (mild DAT). Additionally, we tested the correlations between standing balance and different aspects of cognitive function.

Design: Cross-sectional data are drawn from a longitudinal study baseline

Setting: Data were collected nationwide from nine participating institutions (Alzheimer’s Disease Center or other affiliated longitudinal studies of aging and dementia).

Participants: Data of 850 participants aged 65+ (Normal Control (NC) = 558, MCI = 184, and mild DAT = 108) were drawn from the Advancing Reliable Measurement in Alzheimer’s Disease and Cognitive Aging (ARMADA) study. Race and ethnicity distribution were representative of the general population in the US.

Interventions: NA. Observational Study.

Main Outcome Measures: The standing balance test and seven cognitive assessments were administered as part of the standard NIH Toolbox motor and cognition battery. The standing balance test measures the ability to maintain balance on both a solid and a foam surface with and without eyes opening. Participants wear accelerometers at waist level to document postural sway.

Results: After controlling for age effect, older adults with mild DAT had significantly lower score in standing balance than cognitively normal older adults (mild DAT= 88.48, NC=93.10, Mean difference: -4.63, p<.01) or those with MCI (mild DAT=88.48, MCI=93.09, Mean difference: -4.61, p<.01). Poorer standing balance was associated with lower scores in executive function, processing speed, working memory, episodic memory, vocabulary, and general cognition. All effect sizes were small with partial eta square ranged from .011 to .026.

Conclusions: Older adults with mild DAT performed poorer in the standing balance test than those with MCI or cognitively healthy. Fall prevention and balance training should start at the early stages of cognitive impairment.

Author(s) Disclosures: NA