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Association of Balance Impairment with Risk of Incident Dementia among Older Adults

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The Journal of Prevention of Alzheimer's Disease Aims and scope Submit manuscript

Abstract

Background

A growing body of data suggests that balance impairment may be linked to the onset of dementia.

Objectives

However, a large-scale epidemiologic investigation is needed to clarify its association in older adults.

Design

A retrospective-prospective hybrid database.

Setting

Cox proportional hazards regression model was used to assess the relationship between balance impairment and the risk of incident dementia, and the results were provided as adjusted hazard ratios (aHR) with 95% confidence intervals (CI). All participants were tracked until the date of incident dementia, death, or 31 December 2019 whichever came first.

Participants

We analyzed 143,788 older adults who had at least one health screening between 2009 and 2019 from the Korea National Health Insurance Service-Senior Cohort.

Measurements

A total of 3,774 cases of dementia were discovered throughout 850,425 person-years of follow-up investigation. Balance impairment was associated with a risk of dementia compared to those without balance impairment (adjusted hazard ratio [aHR] 1.83; 95% CI, 1.69–2.00; P value <0.001).

Results

Risks of the Alzheimer’s disease (aHR, 1.80; 95% CI, 1.65–1.96; P for trend <0.001) and the vascular dementia (aHR, 2.94; 95% CI, 1.89–4.58; P for trend <0.001) showed comparable trends and findings.

Conclusions

Balance impairment was found to be independently associated with an increased risk of dementia in older adults.

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References

  1. Michalska J, Juras G, Kamieniarz A, et al. Characteristics of transitional locomotor tasks performed by patients with dementia. Exp Brain Res. 2022;240(5):1605–16. DOI: https://doi.org/10.1007/s00221-022-06355-1

    Article  PubMed  Google Scholar 

  2. McKhann GM, Knopman DS, Chertkow H, et al. The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement. 2011;7(3):263–9. DOI: https://doi.org/10.1016/j.jalz.2011.03.005.

    Article  PubMed  Google Scholar 

  3. Patterson C. World alzheimer report 2018. 2018. https://www.alzint.org/resource/world-alzheimer-report-2018. Accessed 19 December 2022 (no DOI for this source as it is a web report).

  4. Grande G, Qiu C, Fratiglioni L. Prevention of dementia in an ageing world: evidence and biological rationale. Ageing Res Rev. 2020;64:101045. DOI: https://doi.org/10.1016/j.arr.2020.101045.

    Article  PubMed  Google Scholar 

  5. Szczepańska-Gieracha J, Cieślik B, Chamela-Bilińska D, Kuczyński M. Postural stability of elderly people with cognitive impairments. Am J Alzheimers Dis Other Demen 2016;31(3):241–6. DOI: https://doi.org/10.1177/1533317515602547.

    Article  PubMed  Google Scholar 

  6. Kueper JK, Speechley M, Lingum NR, Montero-Odasso M. Motor function and incident dementia: a systematic review and meta-analysis. Age Ageing. 2017;46(5):729–38. DOI: https://doi.org/10.1093/ageing/afx084.

    Article  PubMed  Google Scholar 

  7. Montero-Odasso M, Oteng-Amoako A, Speechley M, et al. The motor signature of mild cognitive impairment: results from the gait and brain study. J Gerontol A Biol Sci Med Sci. 2014;69(11):1415–21. DOI: https://doi.org/10.1093/gerona/glu155.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Wang L, Larson EB, Bowen JD, van Belle G. Arch Intern Med. 2006;166(10):1115–20. DOI: https://doi.org/10.1001/archinte.166.10.1115.

    Article  PubMed  Google Scholar 

  9. Seidler RD, Bernard JA, Burutolu TB, et al. Motor control and aging: links to age-related brain structural, functional, and biochemical effects. Neurosci Biobehav Rev. 2010;34(5):721–33. DOI: https://doi.org/10.1016/j.neubiorev.2009.10.005.

    Article  CAS  PubMed  Google Scholar 

  10. Ries JD. Rehabilitation for individuals with dementia: facilitating success. Curr Geriatr Rep. 2018;7(1):59–70. DOI: https://doi.org/10.1007/s13670-018-0237-1.

    Article  Google Scholar 

  11. Narazaki K, Nofuji Y, Kumagai S. Association between middle-to late-life physical performance and incident Alzheimer’s disease: Recent findings and potential mechanisms. J Phys Fit Sports Med. 2017;6(4):191–200. DOI: https://doi.org/10.7600/jpfsm.6.191.

    Article  Google Scholar 

  12. Montero-Odasso M, Pieruccini-Faria F, Ismail Z, et al. CCCDTD5 recommendations on early non cognitive markers of dementia: A Canadian consensus. Alzheimers Dement (N Y). 2020;6(1):e12068. DOI: https://doi.org/10.1002/trc2.12068.

    Article  PubMed  Google Scholar 

  13. Cheol Seong S, Kim YY, Khang YH, et al. BALANCE IMPAIRMENT AND DEMENTIA Health Information Database of the National Health Insurance Service in South Korea. Int J Epidemiol. 2017;46(3):799–800. DOI: https://doi.org/10.1093/ije/dyw253.

    PubMed  Google Scholar 

  14. Kim YI, Kim Y-Y, Yoon JL, et al. Cohort Profile: National health insurance service-senior (NHIS-senior) cohort in Korea. BMJ Open. 2019;9(7):e024344. DOI: https://doi.org/10.1136/bmjopen-2017-01664.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Intern Med. 2007;147(8):573–7. DOI: https://doi.org/10.1016/j.ijsu.2014.07.014.

    Article  PubMed  Google Scholar 

  16. Jeong S, Oh YH, Choi S, et al. Association of Nonalcoholic Fatty Liver Disease with Incident Dementia Later in Life Among Elder Adults. Clin Mol Hepatol. 2022. DOI: 10.3350.

  17. Vafaei A, Aubin MJ, Buhrmann R, Kergoat MJ, Aljied R, Freeman EE. Interaction between visual acuity and peripheral vascular disease with balance. J Am Geriatr Soc. 2018;66(10):1934–9. DOI: https://doi.org/10.1111/jgs.15490.

    Article  PubMed  Google Scholar 

  18. Sundararajan V, Henderson T, Perry C, Muggivan A, Quan H, Ghali WA. New ICD-10 version of the Charlson comorbidity index predicted in-hospital mortality. J Clin Epidemiol. 2004;57(12):1288–94. DOI: https://doi.org/10.1016/j.jclinepi.2004.03.01

    Article  PubMed  Google Scholar 

  19. Lee A, Richards M, Chan WC, Chiu H, Lee R, Lam L. Poor Balance as a Noncognitive Predictor of Incident Dementia. J Am Geriatr Soc. 2015;63(8):1701–2. doi: https://doi.org/10.1111/jgs.13587

    Article  PubMed  Google Scholar 

  20. Sattler C, Erickson KI, Toro P, Schröder J. Physical fitness as a protective factor for cognitive impairment in a prospective population-based study in Germany. J Alzheimers Dis. 2011;26(4):709–18. DOI: https://doi.org/10.3233/JAD-2011-110548

    Article  PubMed  Google Scholar 

  21. Montero-Odasso M, Annweiler C, Hachinski V, Islam A, Toma N, Vasudev A. Vascular burden predicts gait, mood, and executive function disturbances in older adults with mild cognitive impairment: results from the gait and brain study. J Am Geriatr Soc. 2012;60(10):1988–90. DOI: https://doi.org/10.1111/j.1532-5415.2012.04180.x

    Article  PubMed  Google Scholar 

  22. Pugh KG, Lipsitz LA. The microvascular frontal-subcortical syndrome of aging. Neurobiol Aging. 2002;23(3):421–31. DOI: https://doi.org/10.1016/j.neubiorev.2009.10.005.

    Article  PubMed  Google Scholar 

  23. Montero-Odasso M, Hachinski V. Preludes to brain failure: executive dysfunction and gait disturbances. Neurol Sci. 2014;35(4):601–4. DOI: https://doi.org/10.1007/s13670-018-0237-1

    Article  PubMed  Google Scholar 

  24. Camicioli R, Panzer VP, Kaye J. Balance in the healthy elderly: posturography and clinical assessment. Arch Neurol. 1997;54(8):976–81. DOI: https://doi.org/10.1177/1533317515602547

    Article  CAS  PubMed  Google Scholar 

  25. Longstreth W, Manolio TA, Arnold A, et al. Clinical correlates of white matter findings on cranial magnetic resonance imaging of 3301 elderly people: the Cardiovascular Health Study. Stroke. 1996;27(8):1274–82. DOI: https://doi.org/10.1016/j.jalz.2011.03.005

    Article  PubMed  Google Scholar 

  26. Ashiri M, Francisco C, Winkler J, Lithgow B, Moussavi Z, editors. Postural Sway Characteristics Are Affected by Alzheimer’s Disease. 2021 43rd Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC); 2021: IEEE. DOI: https://doi.org/10.1109/EMBC46164.2021.96307461

  27. de Leeuw FE, Barkhof F, Scheltens P. White matter lesions and hippocampal atrophy in Alzheimer’s disease. Neurology. 2004;62(2):310–2. DOI: https://doi.org/10.1212/01.WNL.0000103289.03648.AD2

    Article  PubMed  Google Scholar 

  28. Garnier-Crussard A, Bougacha S, Wirth M, et al. White matter hyperintensity topography in Alzheimer’s disease and links to cognition. Alzheimers Dement. 2022;18(3):422–33. DOI: https://doi.org/10.1002/alz.12410

    Article  CAS  PubMed  Google Scholar 

  29. Kannan L, Bhatt T, Zhang A, Ajilore O. Association of balance control mechanisms with brain structural integrity in older adults with mild cognitive impairment. Neurosci Lett. 2022;783:136699. DOI: https://doi.org/10.1016/j.neulet.2022.136699

    Article  CAS  PubMed  Google Scholar 

  30. Möller C, Vrenken H, Jiskoot L, et al. Different patterns of gray matter atrophy in early-and late-onset Alzheimer’s disease. Neurobiol Aging. 2013;34(8):2014–22. DOI: https://doi.org/10.1016/j.neurobiolaging.2013.02.013

    Article  PubMed  Google Scholar 

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Acknowledgements

None.

Funding

The sponsors had no role in the design and conduct of the study; in the collection, analysis, and interpretation of data; in the preparation of the manuscript; or in the review or approval of the manuscript.

Author information

Author notes

  1. These authors contributed equally.

Authors and Affiliations

  1. Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea

    H. J. Kim

  2. Department of Biomedical Informatics, CHA University School of Medicine, CHA University, Seongnam, South Korea

    S. Jeong

  3. Department of Family Medicine, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong, South Korea

    Yun Hwan Oh

  4. Department of Otorhinolaryngology, Jeju National University Hospital, Jeju National, University College of Medicine, Jeju, South Korea

    Michelle J. Suh

  5. Department of Otorhinolaryngology, Jeju National University College of Medicine, Aran 13 gil 15, Jeju, 63241, South Korea

    Jee Young Suh

Authors
  1. H. J. Kim
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  2. S. Jeong
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  3. Yun Hwan Oh
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Contributions

Conceptualization: Yun Hwan Oh, Jee Young Suh; Formal analysis: Hye Jun Kim; Investigation: Seogsong Jeong; Writing—original draft: Hye Jun Kim, Seogsong Jeong; Writing—review and editing: Yun Hwan Oh, Jee Young Suh.

Corresponding authors

Correspondence to Yun Hwan Oh or Jee Young Suh.

Ethics declarations

Conflict of Interest: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethics approval: This study was approved as exempt from Institutional Review Board of Jeju National University Hospital (approval No. JNUH IRB File No.2021-07-008). Since the database was made anonymous in accordance with strict confidentiality guidelines, the necessity to obtain informed consents was waived.

Additional information

Data Sharing

We have not previously published or currently in press works stemming from this same dataset. The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Kim, H.J., Jeong, S., Oh, Y.H. et al. Association of Balance Impairment with Risk of Incident Dementia among Older Adults. J Prev Alzheimers Dis 11, 130–137 (2024). https://doi.org/10.14283/jpad.2023.79

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  • DOI: https://doi.org/10.14283/jpad.2023.79

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