Recent drinking in alcohol use disorder as a modifiable risk factor of postural tremor and instability in mild...

Alcohol consumption exacerbates health problems, including all-cause dementia, that will likely include 15%-20% with mild cognitive impairment (MCI), often heralding dementia. Despite the increasing prevalence of MCI with hazardous drinking, this comorbidity is seldom considered yet may be a contributor to exacerbating age-related motor decline, debilitating morbidity, and premature mortality.

This mixed cross-sectional/longitudinal analysis included upward of 381 test sessions of balance platform testing using a microcomputer-controlled force plate for sway and tremor detection. Participants included 137 control, 54 MCI, 18 MCI + alcohol use disorder (AUD), and 17 AUD age 45-90 years. Test conditions were standing still with feet together or apart, eyes open or closed or doing mental math.

Controls exhibited greater postural instability and tremor velocity with advancing age in all conditions. Control values were used to adjust for age and sex in all conditions for all group analyses. The MCI group did not differ from the controls in any condition. By contrast, the MCI + AUD and AUD groups exhibited significantly greater age effects than controls in 11 conditions, especially when stability was challenged by standing with feet together or while performing mental math. Exploratory analyses in the combined MCI + AUD and AUD groups identified relations between greater postural instability and more alcohol consumed in the past year. These findings are preliminary given the small samples.

Age, irrespective of diagnosis, imbues liability onto postural stability, evidenced by longer sway paths and greater tremor velocity, especially under challenging conditions. Although the MCI group showed no evidence for disturbed balance metrics beyond those observed in controls, MCI participants comorbid for AUD exhibited deficits at similar levels to those shown by AUD participants in quiet standing, indicating recent drinking in individuals with a history of AUD as a modifiable risk factor for postural instability, a liability for falls and dementia.