White matter lesions and disequilibrium in older people. I. Case-control comparison.

Objective: To investigate the relationship between subcortical white matter lesions identified on magnetic resonance imaging and gait and balance problems in older people.

Design: Magnetic resonance imaging scans of the brain in 27 community-dwelling older patients (> 75 years of age) who had subjective and objective abnormalities of gait and balance of unknown cause were compared with those of 27 age- and sex-matched control subjects. The T2-weighted intense lesions of the subcortical white matter were graded on a scale of 0 to 2.

Posturography and balance problems in older people.

Objective: To determine which measurements and test conditions on posturography are most useful for identifying balance problems in older people.

Subjects: Two samples of 70 community-dwelling older subjects (> 75 years). One group (controls) considered their balance normal for their age, and the other (patients) complained of imbalance.

Comparison of static and dynamic posturography in young and older normal people.

Objective: To measure sway velocity during static and dynamic posturography in "normal" older people and to determine which tests best distinguish young from older subjects.

Subjects: A sample of 30 young (18-39 years) and 82 community-dwelling older (> 75 years) subjects who reported normal balance underwent a battery of balance tests.

Measurements: Velocity and frequency of sway, Tinetti gait and balance score, self-reported fear of falling and number of falls.

The effect of aging on visual-vestibuloocular responses.

To determine age-related changes in oculomotor function we measured vestibuloocular (VOR), optokinetic (OKN), and visual-vestibular responses in a large group of normal subjects over the age of 75 years and compared the results with those from a group of young adults. Compared with the young subjects, older subjects had: (1) an amplitude-dependent decrease in VOR gain, (2) a shorter dominant VOR time constant, (3) a lower OKN slow-phase velocity saturation, and (4) a decreased ability to enhance and suppress the VOR with vision. These functional changes in older subjects are presumably secondary to well-documented, age-related changes in the sensory and neural elements of the visual-vestibulooculomotor pathways.