500 Section - Vestibular–Cognitive Interactions Under Dynamic Balance Demands in Older Adults: Implications for Early Detection and Digital Assessment

Objectives : Age-related vestibular decline affects sensory integration, gaze stabilization, and dynamic postural control, and is increasingly associated with attentional and executive processes. These systems interact during mobility tasks, particularly under dual-task conditions that challenge cognitive–motor resource allocation. Traditional vestibular diagnostics (vHIT, caloric testing) lack ecological relevance for community screening. Dynamic measures—such as dynamic visual acuity(DVA), IMU-based gait analysis, and computerized posturography—may better capture subtle balance deficits in communities. This exploratory study examined relationships among vestibular function, cognition, and dynamic balance in community-dwelling older adults to inform digital assessment development for early detection of vestibular decline and functional vulnerability.

Design: Adults aged 55–85 were recruited based on independent ambulation, communication ability, and corrected vision; exclusions included neurological disorders, sensory deficits, and recent musculoskeletal injuries. Assessments used head- and waist-mounted IMUs, a force plate, and LabVIEW-integrated tasks (eyes open/closed standing, foam standing, head rotations). Participants completed single- and dual-task walking with cognitive elements engaging attention and executive control. Measures included center of pressure sway, Timed Up and Go(TUG), IMU-derived head angles, gait spatiotemporal parameters, and DVA. Cognitive and psychological assessments included the Montreal Cognitive Assessment(MoCA-T), Color Trails Test(CTT), Digit Span Test(DST), Activities-specific Balance Confidence Scale(ABC), Dizziness Handicap Inventory(DHI), and Hospital Anxiety and Depression Scale(HADS). Pearson and Spearman correlations examined cross-domain associations.

Results: Forty-one older adults (mean age 72.6±7.3 years) completed testing. Static balance showed weak cognitive associations, whereas dynamic walking and head-movement tasks revealed stronger vestibular–cognitive interactions. Faster gait speed and longer stride length were associated with better attention and executive performance. Dual-task walking with head rotations intensified these interactions. TUG rotation speed correlated with balance confidence and attention. DVA correlated with dual-task gait symmetry.
 

Conclusion: Dynamic vestibular challenges and dual-task walking more sensitively reflected relationships among vestibular function, cognition, and balance control than static measures, supporting sensor-based assessments that better reflect real-world mobility demands.