Inhibition and decision-processing speed are associated with performance on dynamic posturography in older adults
- 67 Downloads
Changes in cognition due to age have been associated with falls and reduced standing postural control. Sensory integration is one component of postural control that may be influenced by certain aspects of cognitive functioning. This study investigated associations between measures of cognitive function and sensory integration capabilities for healthy young and older adults. Dynamic posturography was performed using the Equitest Sensory Organization Test (SOT) protocol to evaluate sensory integration during standing using sway-referencing of the platform and/or visual scene to alter somatosensory and visual inputs. The Equilibrium Score was used as a measure of sway. Cognitive testing examined aspects of cognitive function that have been associated with falls in older adults. A correlational analysis investigated associations between the cognitive measures and postural sway during the altered sensory conditions of the SOT. For older subjects only, slower decision-processing speed was associated with increased sway during SOT conditions whenever somatosensation was altered. Reduced perceptual inhibition was associated with increased sway whenever somatosensation was intact, and particularly when vision was altered in the presence of somatosensation. Visuospatial construct ability was associated with sway only when the eyes were closed during altered somatosensation. Task-switching was associated with sway only when vision and somatosensation were intact. With increased age, deficits in decision speed and inhibition appear associated with the sensory integration crucial for balance maintenance. Associations are modulated by the availability of somatosensation and vision. These associations define situations and individual differences in aspects of cognition that may relate to situational loss of balance in older adults.
KeywordsSensory integration Cognition Posture Balance Aging
Susan Strelinski and Anita Lieb are much appreciated for helping to conduct this research.
This work was funded through the National Institutes of Health (R01 AG14116), and the Pittsburgh Claude D. Pepper Older Americans Independence Center (P30 AG024827).
Compliance with ethical standards
Conflict of interest
The authors have no financial or personal relationships with other people or organizations that could inappropriately influence or bias their work.
- Borger LL, Whitney SL, Redfern MS, Furman JM (1999) The influence of dynamic visual environments on postural sway in the elderly. J Vestib Res Equilib Orientat 9:197–205Google Scholar
- Diamond A (2013) Executive functions. Annu Rev Psychol 64:135–168. https://doi.org/10.1146/annurev-psych-113011-143750 CrossRefGoogle Scholar
- Furman JM, Cass SP (1996) Laboratory testing. In: Baloh RW, Halmagyi M (eds) Electronystagmography and rotational testing. Disorders of the vestibular system. Oxford Press, New YorkGoogle Scholar
- Herman T, Mirelman A, Giladi N, Schweiger A, Hausdorff JM (2010) Executive control deficits as a prodrome to falls in healthy older adults: a prospective study linking thinking, walking, and falling. J Gerontol A Biol Sci Med Sci 65:1086–1092. https://doi.org/10.1093/gerona/glq077 CrossRefGoogle Scholar
- Holewski JJ, Stess RM, Graf PM, Grunfeld C (1988) Aesthesiometry: quantification of cutaneous pressure sensation in diabetic peripheral neuropathy. J Rehabil Res Dev 25:1–10Google Scholar
- Horak FB, Macpherson JM (1996) Postural orientation and equilibrium. In: Rowell L, Shepard NP (eds) Handbook of physiology. Oxford University Press, New York, pp 255–292Google Scholar
- Liu-Ambrose T, Pang MY, Eng JJ (2007) Executive function is independently associated with performances of balance and mobility in community-dwelling older adults after mild stroke: implications for falls prevention. Cerebrovasc Dis 23:203–210. https://doi.org/10.1159/000097642 CrossRefGoogle Scholar
- Martina IS, van Koningsveld R, Schmitz PI, van der Meche FG, van Doorn PA (1998) Measuring vibration threshold with a graduated tuning fork in normal aging and in patients with polyneuropathy. European Inflammatory Neuropathy Cause and Treatment (INCAT) group. J Neurol Neurosurg Psychiatry 65:743–747CrossRefGoogle Scholar
- NeuroCom International Inc (2004) Instructions for use: EquiTest system operator’s manual. Version 8.2. 2018. NeuroCom International Inc, ClackamasGoogle Scholar
- Taylor ME, Lord SR, Delbaere K, Kurrle SE, Mikolaizak AS, Close JC (2017) Reaction time and postural sway modify the effect of executive function on risk of falls in older people with mild to moderate cognitive impairment. Am J Geriatr Psychiatry Off J Am Assoc Geriatr Psychiatry 25:397–406. https://doi.org/10.1016/j.jagp.2016.10.010 CrossRefGoogle Scholar