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Disequilibrium in older people: a prospective study
K A Kerber1, J A Enrietto, K M Jacobson
1Department of Neurology, UCLA School of Medicine, Los Angeles, CA, USA.
Neurology
|August 26, 1998
Summary
Older adults with unexplained disequilibrium experience more falls and show greater brain atrophy and white matter lesions (WML) on MRI scans. These findings suggest small-vessel ischemic disease may cause some cases of balance deterioration in aging individuals.
Area of Science:
- Gerontology
- Neurology
- Neuroimaging
Background:
- Balance problems are common in older adults but often lack a clear cause.
- The etiology of age-related disequilibrium remains unclear, possibly involving normal aging or unidentified neuropathology.
Purpose of the Study:
- To determine the clinical and neuroimaging characteristics of disequilibrium in older individuals.
- To investigate the association between balance issues, falls, and brain changes in the elderly.
Main Methods:
- A longitudinal study involving 29 older adults with disequilibrium and 29 controls over five years.
- Evaluations included neurological exams, balance tests (Tinetti score), fall history, and brain MRI to assess white matter lesions (WML), frontal atrophy (FA), and ventricular-brain ratio (VBR).
Main Results:
- Patients with disequilibrium reported more falls and concerns about falling compared to controls.
- Over five years, patients fell four times more often than controls, with falls strongly correlating with balance measures.
- Significantly higher VBR, WML, and FA were observed in patients compared to controls (p < 0.001).
Conclusions:
- Unexplained disequilibrium in older adults is linked to increased falls, balance deficits, and neuroimaging evidence of brain atrophy and WML.
- Small-vessel ischemic disease is a likely contributor to disequilibrium in some elderly patients.