Effects of vascular risk factors on balance assessed by computerized posturography in the elderly

The purpose of this study was to evaluate the effects of vascular risk factors, isolated or in association, on balance, as assessed by posturographic platform.

One hundred and seven elderly subjects (mean age 73.8+/-5.8), with no cognitive impairment (MMSE>24), able to perform self-care activities and to walk independently for at least 400 meters, free from major diseases. Subjective complaints were assessed by means of the Sickness Impact Profile Questionnaire. The following cardiovascular risk factors were considered: hypercholesterolemia, smoking, hypertension, glucose intolerance, and obesity. Balance tests were performed in three standardized positions (side-by-side, semi-tandem, tandem) on a vertical force platform, from which center of foot pressure positions and displacements were recorded.

A large percentage of enrolled subjects (35.5%) complained of unsteadiness, dizziness or vertigo, but only a few (24=22.4%) reported at least one fall in the 6 months before enrolment in the study. Among the cardiovascular risk factors taken into account, only glucose intolerance and, to a lesser extent, obesity, were associated with worse performance in stabilometric tests, independent of age and sex. Subjects with 3 or more risk factors, compared with those with 2 or less showed worse performance in medio-lateral sway (p=0.001), track length (p=0.05) and elliptical area (p=0.005), in tandem position.

The cumulative presence of cardiovascular risk factors may contribute to impairment of balance in the elderly. This effect may be due to subclinical damage of that part of the nervous system controlling balance.