Balance tasks requiring inhibitory control; a scoping review of studies in older adults

Age-related changes in inhibitory control (IC) affect cognitive as well as physical functioning, but how it affects performance of tasks that integrate IC and balance control is unclear. This review study aims to identify specific tasks that have been used to determine effects of IC on balance performance in older adults, and analyse task-specific features as well as reported effects.

Based on a comprehensive literature search, a scoping review considered all studies that involved IC as part of static or dynamic balance tasks in healthy adults over 65. Studies which only involved IC as part of an -additional- cognitive task during a balance task were excluded.

Eleven studies met the inclusion criteria for this review. Eight out of the 11 studies focused on voluntary stepping; two studies used gait or gait initiation, and one study used foot lift as a balance task. Ten studies included conditions that required some form of perceptual inhibition, and 6 out of the 11 studies included conditions involving some form of motor inhibition. With few exceptions, all inhibitory control conditions showed a decreased task performance in older adults.

Although most studies addressed IC during some form of stepping, the approaches were heterogeneous in terms of tasks, outcome measures and standardisation. Despite the heterogeneity, the available studies unequivocally demonstrate the importance of IC for task performance. The discussion addresses aspects which are important in furthering our understanding of age-related changes in IC and its impact on performance.