Balance perception as a potential tool for screening postural imbalance in the Timed Up and Go test among cognitively impaired older adults

Abstract Postural Imbalance (PI) is a common complaint in cognitively impaired older adults. It is unknown whether the Cognitive Impairment (CI) affects the validity and interpretability of balance perception in this population when standing up or walking. This study aims to investigate the validity of self-reported PI perception to screen performance limitations related to the task proposed by the Timed Up and Go (TUG) test in older adults with CI. This is a cross-sectional study using the data collected from older people evaluated in 2019-2020 at a specialized geriatric care facility. The sample was composed of 136 older adults with CI identified by the Mini-Mental State Examination (MMSE). The participants were questioned about PI perception (test index) and were submitted to the TUG test (reference standard; cutoff point>20 seconds). The subject’s answers were confirmed by the accompanying caregiver. The Sensitivity (SE), Specificity (SP), Positive Predictive Values (PPV) and Negative Predictive Values (NPV) were estimated, measuring the agreement percentage (Cohen’s Kappa test). Out of the 136 individuals studied herein, 60.3% (n=82) had self-reported PI and 25.3% (n=35) experienced it during the TUG test. Validity estimates presented high sensitivity and NPV values (SE=85.7%, SP=48.5%, PPV=36.6%, NPV=90.7%). The agreement percentage between the two tools in the overall sample was 58.1%. Despite the low agreement between instruments, the self-reported PI showed low false-negative percentages, indicating that it could be a potential tool for screening limitations in the TUG test, favoring the identification of individuals at risk of imbalance among older adults with CI.