The Role of Cognitive Factors in Old Age Balance Impairments

The ability of human beings to perform more than one task at a time has long been focus of study in the literature on human attention and memory. Older adults are more penalized when they must divide their attention between two input resources i.e input and holding or holding and responding. Falls have potentially devastating physical, social and psychological consequences. Falling is one of the most serious problems associated with ageing. Sensory system deteriorates with age, increased attention is allocated to “HIGHTEN” the signal coming from this system in order to gain necessary information for postural control. Older adults show marked reduction in the ability to perform the postural and cognitive task simultaneously. A study was conducted by physiotherapy and psychology students in a small town of Haryana on institutionalized older adults in which Dual task training under various sets of instruction that is Fixed priority and Variable priority instruction sets effects the balance who are living in residential care facilities. Tinneti Performance Oriented Mobility Assessment (POMA) and Mini mental status examination were used as tools to assess balance and cognitive abilities. Various studies related to the role of cognitive factors in balance impairments were reviewed. Data was analyzed using SPSS 13.0 software packages and paired sample t –test within the group and independent sample t – test between the groups with p – value at a significance level of p < 0.05 was used. The result of the study supported the hypothesis that there is significant improvement in balance of institutionalized elderly people who received dual task training with variable priority instruction set. (p < 0.001). The use of validated measurement tool like Tinnetti performance oriented mobility assessment on balance allowed clearer interpretation of the results. There is improvement in TPOMA Scores after 4 weeks training program in both groups. This shows that cognitive factors do play an important role in maintaining balance and coordination. Any impairment related to sensory system or cognition leads to balance impairments and increased risk for falls.