POSTUROGRAPHY AND BALANCE PROBLEMS IN OLDER-PEOPLE

OBJECTIVE: To determine which measurements and test conditions on post urography are most useful for identifying balance problems in older pe ople. SUBJECTS: Two samples of 70 community-dwelling older subjects (> 75 years). One group (controls) considered their balance normal for t heir age, and the other (patients) complained of imbalance. MEASUREMEN TS: Velocity of sway on static (with and without foam) and dynamic pos turography, Tinetti gait and balance score, self-reported fear of fall ing, and number and circumstances of falls. RESULTS: Mean sway velocit y was significantly increased in patients compared with controls. The greatest difference be tween patients and controls occurred with measu res of anterior-posterior sway velocity during angular tilt of the pla tform. Sway velocity was not significantly increased in patients or co ntrols who reported falls compared with those who did not report falls . Even when comparing those who fell as a result of loss of balance wi th those who fell because of trips or slips, there was no significant difference in sway velocity. By contrast, those who reported fear of f alling (patients and controls) had significantly increased sway veloci ty 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 compa red with age-matched controls, and the difference is greater with dyna mic posturography than with static posturography. However, the posturo graphy data provided little information about the cause of the imbalan ce and did not correlate with the frequency of reported falls.