A multimodal assessment of balance in elderly and young adults.

Gregory W King,Keyna K Chertoff,Leticia Brotto,An-Lin Cheng,Marco Brotto,Eduardo L Abreu,Patricia J Kelly

doi:10.18632/oncotarget.7758

Gregory W King, Keyna K Chertoff + Show 5 more

Open Access

https://doi.org/10.18632/oncotarget.7758

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Abstract

Falling is a significant health issue among elderly adults. Given the multifactorial nature of falls, effective balance and fall risk assessment must take into account factors from multiple sources. Here we investigate the relationship between fall risk and a diverse set of biochemical and biomechanical variables including: skeletal muscle-specific troponin T (sTnT), maximal strength measures derived from isometric grip and leg extension tasks, and postural sway captured from a force platform during a quiet stance task. These measures were performed in eight young and eleven elderly adults, along with estimates of fall risk derived from the Tinetti Balance Assessment. We observed age-related effects in all measurements, including a trend toward increased sTnT levels, increased postural sway, reduced upper and lower extremity strength, and reduced balance scores. We observed a negative correlation between balance scores and sTnT levels, suggesting its use as a biomarker for fall risk. We observed a significant positive correlation between balance scores and strength measures, adding support to the notion that muscle strength plays a significant role in postural control. We observed a significant negative correlation between balance scores and postural sway, suggesting that fall risk is associated with more loosely controlled center of mass regulation.

Highlights

Falling poses a significant health risk for the elderly
To identify the potential for an interactive fall risk assessment strategy, we investigated the relationship among specific troponin T (sTnT), muscle strength, sway, and balance score in a group of healthy, community-dwelling elderly adults when compared to a group of healthy young adults
We hypothesized that elderly adults, compared to young, would exhibit altered indicators of fall risk: (1) larger levels of sTnT and sway, reduced levels of upper and lower extremity strength, and lower balance scores; and (2) that changes in STnT, sway, and strength would have a significant correlation with balance scores

Summary

INTRODUCTION

Falling poses a significant health risk for the elderly. As the baby boom generation moves into the over age 65 demographic, the number of age-related falls will increase, highlighting the need for accurate and effective fall risk assessment tools. We selected a quiet standing task for the present study because the postural sway outputs from the proprioceptive system are likely related to upper and lower extremity muscle strength and to serum biomarkers for muscle health, skeletal muscle-specific troponin T, sTnT. To identify the potential for an interactive fall risk assessment strategy, we investigated the relationship among sTnT, muscle strength, sway, and balance score in a group of healthy, community-dwelling elderly adults when compared to a group of healthy young adults. We hypothesized that elderly adults, compared to young, would exhibit altered indicators of fall risk: (1) larger levels of sTnT and sway, reduced levels of upper and lower extremity strength, and lower balance scores; and (2) that changes in STnT, sway, and strength would have a significant correlation with balance scores

RESULTS

DISCUSSION

Procedures and measurements