Brain Functional Alterations Associated With Postural Stability Across the Frailty Continuum: A Resting-State fMRI...

Area of Science:

• Gerontology
• Neuroscience
• Medical Imaging

Background:

• Frailty is a geriatric syndrome with declining physical function and increased fall risk.
• Diminished postural stability is a key frailty symptom, but its neural basis is unclear.
• Understanding brain activity in frail older adults is crucial for addressing balance impairments.

Purpose of the Study:

• To investigate resting-state brain functional activity in older adults across frailty spectrums.
• To explore the relationship between brain activity and postural stability in frail individuals.
• To identify neural correlates of balance impairments in aging.

Main Methods:

• Sixty-eight older adults categorized into non-frail, pre-frail, and frail groups.
• Postural stability assessed using the Huber®360 system.
• Resting-state fMRI (rs-fMRI) analyzed for Amplitude of Low-Frequency Fluctuations (ALFF) and Regional Homogeneity (ReHo).

Main Results:

• Frail and pre-frail groups were older with poorer physical performance and more comorbidities.
• Decreased ALFF observed in pre-frail (inferior frontal gyrus/insula) and frail (cerebellum) groups.
• Frail group showed decreased ReHo in cerebellum/pons and increased ReHo in temporal/occipital regions.
• ALFF and ReHo correlated with postural stability measures and functional performance (SPPB, TUGT).

Conclusions:

• Resting-state brain function differs significantly across frailty levels, involving cerebellum-pons and cognition networks.
• Functional brain abnormalities are linked to reduced postural stability in frail older adults.
• Neuroimaging findings support early frailty screening and balance interventions.