Body Balance Maintenance Systems, Risk of Falls and Fear of Falling in Elderly and Oldest-Old

Introduction: Loss of balance limits the life of the elderly people as it is related to falls. The balance is maintained by the following four systems: vestibular, visual, and proprioception whose information is organized by the central nervous system. The oldest-old present the highest prevalence of falls and are least studied.

Objectives: This study aims to study the body balance mechanisms, risk of falls, and fear of falling in elderly and oldest-old.

Methods: Two groups of subjects, 32 elderly (range, 60-69 years) and 30 oldest-old (80 years or more) performed cognitive screening, Timed Up and Go (risk of falls), Falls Efficacy Scale (fear of falling), and Sensory Organization Test (foam-laser dynamic posturography).

Results: The oldest individuals performed worse in all Sensory Organization tests, significantly in those with proprioception conflict. Significant differences were observed between age groups in the systems—visual (91.1 ± 6.1 and 54.8 ± 43.7), vestibular (76.5 ± 9.8 and 38.3 ± 33.3), and visual preference (78.9 ± 17.8 and 64.2 ± 23.3), with similar performance in proprioception (86.8 ± 7.9 and 83.8 ± 17.3). Timed Up and Go and Falls Efficacy Scale scores differed significantly between groups, and associated with scores of balance maintenance systems. The association between risk of fall and the visual system was affected by the cognitive screening scores and fear of falling. Physical activity and education were associated with scores of balance-maintenance-systems.

Conclusion: Balance-maintenance systems that were most affected were the vestibular and visual systems. Differences between elderly and oldest individuals were higher than expected for the visual and vestibular systems, but they were smaller in the proprioception system.

Keywords: postural balance, aged 80 and over, aged.