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Posturography and Clinical Assessment

Richard Camicioli, MD; Victoria P. Panzer, PhD; Jeffrey Kaye, MD

Arch Neurol. 1997;54(8):976-981.

Abstract
Objectives
To measure balance changes in the healthy elderly using quantitative dynamic posturography. To relate these changes to clinical measures of balance and gait.

Design
Elderly subjects screened for health criteria in a longitudinal study were examined using standardized cognitive, neurological, and performance-based tests. Quantitative posturography (Equitest, Neurocom International, Clackamas, Ore) was performed to determine the subject's response to sensory (Sensory Organization Test) and motor perturbations (Motor Coordination Test).

Subjects
Thirty-three healthy, old old subjects (80 years; mean±SD age, 88±5 years) were compared with 15 subjects younger than 80 years (mean±SD age, 72±3 years). All were free of centrally active medications.

Results
The old old had worse quantitative equilibrium scores compared with subjects younger that 80 years when proprioceptive input was inaccurate and visual input was either preserved or completely absent. Old old subjects showed diminished adaptation to repeated platform rotations and fell more frequently during posturography. Quantitative balance measures correlated with age and functional measures of balance (Tinetti Balance Scale score, timed 1 leg standing).

Conclusions
Progressive, functionally evident, age-related quantitative balance changes occur independent of typical geriatric pathological changes. These data should facilitate clinical decisions by allowing the distinction to be made between age-related and pathological changes.

Author Affiliations
From the Departments of Neurology, Veterans Affairs Medical Center and Oregon Health Sciences University (Drs Camicioli and Kaye), and Center for Research on Environmental and Occupational Toxicology (Dr Panzer), Portland, Ore. Dr Panzer is now with Brookside Research and Development, Brewster, NY.

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