POSTUROGRAPHY AND BALANCE PROBLEMS IN OLDER-PEOPLE

OBJECTIVE: To determine which measurements and test conditions on posturography are most useful for identifying balance problems in older people. SUBJECTS: Two samples of 70 community-dwelling older subjects (> 75 years). One group (controls) considered their balance normal for their age, and the other (patients) complained of imbalance. MEASUREMENTS: Velocity of sway on static (with and without foam) and dynamic posturography, Tinetti gait and balance score, self-reported fear of falling, and number and circumstances of falls. RESULTS: Mean sway velocity was significantly increased in patients compared with controls. The greatest difference be tween patients and controls occurred with measures of anterior-posterior sway velocity during angular tilt of the platform. Sway velocity was not significantly increased in patients or controls who reported falls compared with those who did not report falls. Even when comparing those who fell as a result of loss of balance with those who fell because of trips or slips, there was no significant difference in sway velocity. By contrast, those who reported fear of falling (patients and controls) had significantly increased sway velocity compared with those who did not report fear of falling. CONCLUSION: On average, velocity of sway (particularly in the anterior-posterior direction) is higher in older subjects who complain of imbalance compared with age-matched controls, and the difference is greater with dynamic posturography than with static posturography. However, the posturography data provided little information about the cause of the imbalance and did not correlate with the frequency of reported falls.