Concurrent validity of clinical balance tests for older adults with cognitive impairment

Abstract

Older adults with cognitive impairment frequently have reduced balance and are at high risk for falling.  We investigated the concurrent validity of the Physiological Profile Assessment (PPA) and the Timed Up and Go (TUG) test with computerised posturography in 13 older adults (mean (SD) age 80 (8) years) with mild-to-moderate cognitive impairment (mean (SD) Mini-Mental State Examination score, 19 (9)). Spearman’s rho demonstrated: moderately good positive correlation between  PPA (muscle strength) and posturography rising index (r_s = 0.699, p = 0.01) and posturography mediolateral sway during eyes open standing on a foam surface (r_s = 0.604, p = 0.04); good negative correlations between PPA anteroposterior sway (eyes closed) and posturography sway velocity (eyes open) standing on foam (r_s = –0.745, p = 0.01) and Romberg ratios of PPA and posturography (r_s = –0.698, p = 0.02); moderately good positive correlations between TUG and posturography (left step quick turn time; left turn sway; r_s = 0.548, p = 0.04; 0.646, p = 0.02) and good-to-excellent negative correlation between TUG and posturography (rising index r_s = –0.719, p = 0.01). Both tests appear valid measures of balance in older adults with mild-to-moderate cognitive impairment; however, we suggest both are used.