Balance in the healthy elderly - Posturography and clinical assessment

Objectives: To measure balance changes in the healthy elderly using quantitative dynamic posturography. To relate these changes to clinical measures of balance and gait. Design: Elderly subjects screened for health criteria in a longitudinal study were examined using standardized cognitive, neurological, and performance-based tests. Quantitative posturography (Equitest, Neurocom International, Clackamas, Ore) was performed to determine the subject's response to sensory (Sensory Organization Test) and motor perturbations (Motor Coordination Test). Subjects: Thirty-three healthy, old old subjects (greater than or equal to 80 years; mean +/- SD age, 88 +/- 5 years) were compared with 15 subjects younger than 80 years (mean +/- SD age, 72 +/- 3 years). All were free of centrally active medications. Results: The old old had worse quantitative equilibrium scores compared with subjects younger that 80 years when proprioceptive input was inaccurate and visual input was either preserved or completely absent. Old old subjects showed diminished adaptation to repeated platform rotations and fell more frequently during posturography. Quantitative balance measures correlated with age and functional measures of balance (Tinetti Balance Scale score, timed 1 leg standing). Conclusions: Progressive, functionally evident, age-related quantitative balance changes occur independent of typical geriatric pathological changes. These data should facilitate clinical decisions by allowing the distinction to be made between age-related and pathological changes.