Postural instability in the digital age: A scoping review of screen exposure and balance outcomes in community-dwelling older adults

Background: Digital screen use is increasingly common among older adults, yet its implications for balance and postural control are not well defined. Age-related sensory, vestibular and cognitive changes may increase vulnerability to balance disturbances during screen-based activities. Objective: To map and describe how screen exposure has been explored in relation to balance-related outcomes in community-dwelling adults aged 60 years and older. Methods: A scoping review was conducted following Joanna Briggs Institute guidance and the PRISMA-ScR framework. Systematic searches of eight electronic databases identified studies published in English between December 2000 and June 2024. Observational and experimental studies assessing any form of digital screen exposure in relation to balance, gait, vestibulo-ocular function, or dizziness in adults aged ≥60 years were eligible. Data were charted descriptively to map exposure types, balance domains, measurement tools, and methodological characteristics. Results: Five studies met the inclusion criteria. Screen exposures included total daily screen time, smartphone use during walking, sustained near-focus visual tasks, and immersive or visually provocative digital environments. Balance-related outcomes encompassed postural sway, gait parameters, dynamic visual acuity, vestibulo-ocular reflex function, and self-reported dizziness. Substantial heterogeneity was observed across exposure definitions, measurement tools, and study designs. Most evidence was cross-sectional or based on short-duration experimental protocols. Conclusion: Evidence examining screen exposure and balance in older adults is limited and methodologically diverse. This scoping review provides a structured mapping of the existing literature rather than an assessment of effects or causality, highlighting gaps to inform future research on digital behaviour and balance in ageing populations.