Impact of aging on postural stability, gait function, and cognitive performance in older adults

Abstract Background & objective Aging is associated with neuromuscular, sensory, and cognitive changes that impair balance and gait, increasing fall risk in older adults. This study evaluates the effects of aging on postural stability, gait function, and their relationship with cognitive performance. Methods A comparative case - control study conducted on 40 participants. Thirty older adults (60–80 years) were divided into two subgroups: 60–69 years (Group 1 A, n = 15) and 70–80 years (Group 1B, n = 15). A control group of 10 young adults (22–35 years) was included. Participants underwent clinical balance tests, computerized dynamic posturography with Sensory Organization Test (SOT), and cognitive evaluations. Statistical analyses included ANOVA, t-tests, and Pearson correlation. Results Older groups showed significant impairments in sharpened Romberg, tandem gait, and Fukuda stepping tests compared to controls ( p < 0.05). Functional Gait Assessment scores were significantly lower in Group 1B (21.2 ± 2.23) than Group 1 A (25.3 ± 1.4) and controls (28.2 ± 1.69). SOT revealed reduced equilibrium scores in older groups, with the steepest decline in Group 1B, particularly in sensory-challenging conditions ( p < 0.001). MoCA scores were lowest in Group 1B (18.1 ± 1.96) compared to Group 1 A (23.1 ± 2.23) and controls (26.3 ± 1.57). P300 latency was significantly prolonged in Group 1B ( p < 0.001). Correlation analysis showed limited associations between cognitive and balance measures, except for a strong negative correlation between P300 latency and SOT condition 3 in Group 1B ( r = -0.775, p = 0.001). Conclusion Aging, especially beyond 70 years, significantly compromises balance and gait, accompanied by cognitive decline. Integrating cognitive and balance assessments may improve fall risk detection and guide targeted rehabilitation in older adults.