Interrelation between functional decline and dementia: The potential role of balance assessment

There has been growing interest in the past few years on the relationship between impairment of motor functions and cognitive decline, so that the first can be considered a marker of dementia. In MCI patients, the deficit in processing visual information interferes with postural control, causing oscillations and instability. Postural control is usually evaluated through the Short Physical Performance Battery (SPPB) test or Tinetti scale, but, to our knowledge, there are no many studies that considered the Biodex Balance System (BBS) in the evaluation of postural controls in MCI patients. The aim of this study was first to confirm the bi- directional relationship between cognitive and motor performance, and then to compare traditional evaluation scales (SPPB and Tinetti) with a biomechanical tool, the BBS.

Observational retrospective study. In 45 elderly patients with cognitive impairment we evaluated cognition, assessed with the MMSE and MoCA, malnutrition with the MNA, and sarcopenia with DEXA (ASMMI). Motor performance was assessed with SPPB, Tinetti, and BBS.

MMSE correlated more with BBS than with the traditional scales, while MoCA was also correlated with SPPB and Tinetti scores.

BBS had a stronger correlation with cognitive performance compared with the traditional scales. The relationship between MoCA executive items and the BBS tests suggests the usefulness of targeted interventions involving cognitive stimulation to improve motor performance, and motor training to slow the progression of cognitive decline, particularly in MCI.