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  • 'Apparently Healthy' Individuals Who Can't Balance on 1 Foot Have Higher Rates of Cerebral Vessel Disease, Cognitive Decline

    A new study from Japan has found that among apparently healthy middle-aged adults, an inability to balance on 1 foot for more than 20 seconds could be an indicator of cerebral small vessel disease (cSVD), a condition that can lead to stroke and cognitive impairment. The same group also showed higher rates of cognitive decline.

    The study tested 1,387 individuals from 49 to 75 years old (average age 67) for postural instability and compared the results with brain MRI scans. The results were e-published ahead of print in the American Heart Association's journal Stroke (abstract only available for free).

    Researchers used 2 tests to measure postural stability: a 1-leg standing time (OLST) assessment, and a posturograph test of center of gravity. For the OLST, subjects were allowed to choose the leg on which they stood and were measured on 2 attempts to balance on 1 foot with eyes open for 1 minute. The posturograph test used a footplate that measured fluctuations in pressure while subjects stood on both feet and viewed a "circular achromatic target" placed 200 centimeters (78.7 inches) away. After sitting for 1 minute, subjects were reassessed while standing with their eyes closed.

    What researchers found was that while a significant correlation existed between OLST results and the posturographic test, only the OLST showed a strong relationship to the presence of cSVD. The correlation was strongest among individuals who were unable to stand on 1 foot longer than 20 seconds. Among these subjects, 2 or more lacunar infarctions occurred at the rate of 34.5%, and 2 or more microbleed lesions were found in 30% of the subjects.

    Researchers also administered tests for dementia, and found a strong correlation between mild cognitive decline and an inability to maintain balance for more than 20 seconds in the OLST. Authors write that this relationship shows that "postural instability might also be a factor involved in the elevated incidence of falls in subjects with dementia."

    "Our data from community-dwelling residents identifies postural instability as a factor in early pathological changes in the brain and functional decline, even in apparently healthy subjects," the authors write. "Our findings incorporate postural instability as an important measure of comprehensive geriatric assessment, and individuals showing postural instability should subsequently receive increased attention because this instability may signal potential brain abnormalities and cognitive decline."

    Research-related stories featured in PT in Motion News are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association's PTNow website.

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