Maintaining dynamic autonomy–safety balance among elderly patients with gait and balance disorders

Abstract Gait and balance disorders have been reported across different age groups, with increasing incidence rates in the aging population. This study aimed to explore the concept of autonomy in people with gait and balance disorders, explain the concept of safety among them, list different clinical scenarios highlighting the autonomy–safety dilemma, and propose public health interventions to promote the safe mobility and functional autonomy of these individuals. According to a systematic review, gait disorders among elderly people often lead to the loss of independence and long-term placement in different institutions (nursing homes, long-term care facilities, old-age homes, etc.). For patients with gait and balance disorders, autonomy involves the personal capacity for self-care, including realizing that cognitive dysfunction or impaired task performance can impair their decision-making ability. Given the increasing incidence of gait and balance disorders among elderly people and their association with falls and other injuries, safe mobility and functional autonomy must be promoted among these individuals. To conclude, the autonomy–safety dilemma among elderly patients with gait and balance disorders must be acknowledged. Targeted interventions involving shared decision-making should be implemented to ensure not only safety but also respect for the autonomy of elderly patients with gait and balance disorders.