Poor Balance Early Sign of Dementia in Oldest Adults

Research suggests that poor balance may be an early sign of late-age dementia. This first-of-its-kind study appears online ahead of print in the Journal of the American Geriatrics Society (doi: 10.1111/jgs.14224).

Previous studies have shown that poor physical performance is linked to increased odds for dementia in people younger than 85. But, until now, researchers didn’t know whether a link between poor physical performance and dementia existed for people 90 years old and older.

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Researchers Szofia S Bullian, MD, University of California at Irvine, and colleagues examined 578 people aged 90 and older who were participants in The 90+ Study (n = 578, mean age 93.3), a community-based longitudinal study in Southern California. Examiners saw the participants every six months to conduct physical and neurological examinations as well as cognitive tests, with the goal of looking critically at aging and dementia specifically.

At the start of the study, about 50% of the participants were cognitively impaired but did not have dementia. Physical performance measures (4-meter walk, 5 chair stands, handgrip, standing balance) were scored from 0 (unable to perform) to 4 (best performance). The remaining participants were cognitively normal. Researchers followed the participants for 2.6 years and, during that time, almost 40% of participants developed dementia.

Poor physical performance in most measures was associated with greater risk of incident dementia over a mean follow-up of 2.6 years (range 0.6–9.0 years). After controlling for potential confounders, standing balance had the strongest association with incident dementia (hazard ratios [HRs] = 1.9–2.5, overall P = .02), followed by 4-meter walk, (HRs = 1.1–1.8, overall P = .04) and handgrip (HRs = 1.0–2.0, overall P = .03).

The researchers suggested that, since walking and standing balance require complex brain activity, testing these functions may help doctors predict who among the “oldest-old” might be most at risk for developing dementia. The researchers also note that future studies could lead to the development of prevention programs and treatment strategies. —Amanda Del Signore