Simple cognitive tests in midlife could predict the likelihood of falling in later life, one of the most common causes of injury and death, new research suggests.
Poor levels of word memory, verbal fluency, processing speed and cognitive ability in our 50s are early indicators of worsening balance in later life, a condition that increases the risk of falls, injury and death, researchers from University College London have found.
The findings also open the intriguing possibility that cognitive training in midlife could have a positive impact on balance as we age.
“Our research highlights that there is strong cognitive component involved in successful balance,” said Dr Joanna Blodgett, lead author of the paper. “Current balance/fall risk interventions tend to focus on physical aspects, such as strength or balance training. However, it may now be useful to investigate if interventions that improve cognition could also improve balance.”
Previous research on balance ability has mainly focused on physical aspects such as underlying musculoskeletal strength or mobility. “Our research shows that given the crucial neural integration of sensory input and motor response required to maintain balance is one of the physical capability measures most closely linked to cognitive ability,” said Blodgett.
Falls are the most common cause of injury-related deaths in people over the age of 75 and cost the NHS around £1bn a year. Hip fractures are the most common cause of accidental death in older people.
But despite their serious consequences, falls in later life are often dismissed as an inevitable part of growing older. Blodgett said that her findings, based on a study of 3,000 people from the MRC National Survey of Health and Development, a British birth cohort study, and published in the Journals of Gerontology, could enable targeted interventions in midlife that will protect people in later life .
The ability to balance relies on cognitive processing of information from three directions, said Blodgett. Firstly, from what we see; secondly, what our body senses through movement and position, and thirdly, stimulation identified by our inner ear and fed back to the brain.
“Simple cognitive tests could identify individuals at risk of poor balance, providing opportunities for both screening and interventions,” she said.
“Understanding these associations earlier in midlife, either before or in the early stages of decline, is particularly important to prevent or mitigate loss of independent mobility.”
No previous study has investigated age-related changes between specific cognitive processes and balance in midlife, said Blodgett, or considered mutual adjustment of multiple cognitive measures. “As such, several of our study findings are novel,” she said.
Blodgett’s research was welcomed by Age UK Policy Manager, Dr Lis Boulton, who said it should be introduced into the NHS’s Health Check for adults in England aged 40 to 74. “These findings could be useful in helping to identify people who might be at greater risk of poor balance in later life and to then give them targeted advice in the form of balance exercises,” she said.
Dawn Skelton, a professor in Aging and Health at Glasgow Caledonian University, said the paper was insightful. “Balance isn’t just about muscle strength in your legs or in your core,” she said. “It’s also about you, your mental capacity and your brain, and how well the brain knows which muscles to turn on and off at what time and how quickly, and which part you need to twist in order to keep yourself up. You need to have lots of things going on in the brain to be able to cope with that.”