AccScience Publishing / AN / Online First / DOI: 10.36922/AN026280033
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ORIGINAL RESEARCH ARTICLE

Assessment of balance function in older adults with and without subjective cognitive decline

Yuting Hu1,2† Haixin Tang1,3† Jie Wu1 Yanan Wang1 Jie Xiang1,3*
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1 Department of Rehabilitation, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
2 Department of Rehabilitation, The Third Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
3 The Second School of Clinical Medicine, Xuzhou Medical University, Xuzhou, Jiangsu, China
†These authors contributed equally to this work.
Advanced Neurology, 026280033 https://doi.org/10.36922/AN026280033
Received: 6 July 2026 | Revised: 26 July 2026 | Accepted: 29 July 2026 | Published online: 12 August 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

As people age, their motor and cognitive functions gradually decline. Changes in balance function may emerge as early as the prodromal phase of cognitive decline. This study aimed to explore differences in balance abilities among older adults with and without subjective cognitive decline (SCD). This cross-sectional study included 31 healthy controls (HCs) and 31 older adults with SCD. Cognition was assessed using the following measures: the Mini-Mental State Examination, the Montreal Cognitive Assessment Scale, the Memory and Executive Screening, the Verbal Fluency Test, the Rey Auditory Verbal Learning Test, the Boston Naming Test, and the Shape Trail Test A and B. The Berg Balance Scale (BBS), the Timed Up and Go test (TUGT), and a quantitative assessment of balance apparatus were used to assess balance functions in all subjects. The Statistical Package for Social Sciences version 27.0 was used to analyze differences between the two groups. Pearson’s correlation coefficients or Spearman’s rank correlation coefficients were used to explore the associations between balance and cognition. Compared to the HC group, the SCD group showed a significant increase in TUGT (p = 0.0004), with a lower BBS score (p < 0.0001). Additionally, older adults with SCD demonstrated a delayed latency of static balance parameters measured by a balance apparatus. The limit of stability significantly decreased (p < 0.0001), and the completion time of the limit of stability was prolonged in older adults with SCD (p = 0.002). Older adults with SCD demonstrated greater reductions in static balance and dynamic balance than HCs. Across both groups, poorer balance abilities were associated with poorer cognitive function. These findings indicate that balance impairments emerge as early as the SCD stage and correlate with early cognitive deterioration, highlighting the importance of incorporating balance assessments into routine clinical screening for populations at risk of dementia.

Keywords
Subjective cognitive decline
Static balance
Dynamic balance
Older adults
Funding
This work was supported by the Science and Technology Plan Program of Xuzhou City (Grant No. KC22130).
Conflict of interest
The authors declare that they have no competing interests.
References
  1. Biasin F, Ceolin C, Celli S, et al. Interrelation between functional decline and dementia: The potential role of balance assessment. Hum Mov Sci. 2023;89:103095. doi: 10.1016/j.humov.2023.103095
  2. Li H, Tan CC, Tan L, Xu W. Predictors of cognitive deterioration in subjective cognitive decline: evidence from longitudinal studies and implications for SCD-plus criteria. J Neurol Neurosurg Psychiatry. 2023;94(10):844-854. doi: 10.1136/jnnp-2022-330246
  3. Xu S, Ren Y, Liu R, et al. Prevalence and Progression of Subjective Cognitive Decline Among Rural Chinese Older Adults: A Population-Based Study. J Alzheimers Dis. 2023;93(4):1355-1368. doi: 10.3233/JAD-221280
  4. Doğancı O, Sertel M. Determination of balance, fall risk, and kinesiophobia in individuals with Alzheimer’s Dementia. Front Psychol. 2025;16:1535440. doi: 10.3389/fpsyg.2025.1535440
  5. Zhang T, Zhang Y, Lv Z, Xiang J. Sarcopenia and motoric cognitive risk syndrome: a moderated mediation model. BMC Geriatr. 2022;22(1):141. doi: 10.1186/s12877-022-02802-4
  6. Taylor ME, Toots A, Lord SR, Payne N, Close JCT. Cognitive Domain Associations with Balance Performance in Community-Dwelling Older People with Cognitive Impairment. J Alzheimers Dis. 2021;81(2):833-841. doi: 10.3233/JAD-201325
  7. Tueth LE, Earhart GM, Rawson KS. Association between falls in Alzheimer disease and scores on the Balance Evaluation Systems Test (BESTest) and MiniBESTest. Somatosens Mot Res. 2021;38(3):248-252. doi: 10.1080/08990220.2021.1959309
  8. Schmidt L, Zieschang T, Koschate J, Stuckenschneider T. Impaired Standing Balance in Older Adults with Cognitive Impairment after a Severe Fall. Gerontology. 2024;70(7):755-763. doi: 10.1159/000538598
  9. Kuan YC, Huang LK, Wang YH, et al. Balance and gait performance in older adults with early-stage cognitive impairment. Eur J Phys Rehabil Med. 2021;57(4):560-567. doi: 10.23736/S1973-9087.20.06550-8
  10. Blackwood J, Amini R, Conti G, Counseller Q, Taylor R, Fayyad D. Balance performance and grip strength as predictors of cognitive function among community-dwelling older adults in the USA. J Frailty Sarcopenia Falls. 2023;8(1):23-31. doi: 10.22540/JFSF-08-023
  11. Ide R, Ota M, Hada Y, et al. Dynamic balance deficit and the neural network in Alzheimer’s disease and mild cognitive impairment. Gait Posture. 2022;93:252-258. doi: 10.1016/j.gaitpost.2022.01.018
  12. Müller K, Fröhlich S, Germano AMC, et al. Sensor-based systems for early detection of dementia (SENDA): a study protocol for a prospective cohort sequential study. BMC Neurol. 2020;20(1):84. doi: 10.1186/s12883-020-01666-8
  13. Fujita K, Sugimoto T, Noma H, et al. Postural Control Characteristics in Alzheimer’s Disease, Dementia With Lewy Bodies, and Vascular Dementia. J Gerontol A Biol Sci Med Sci. 2024;79(4):glae061. doi: 10.1093/gerona/glae061
  14. Yoon B, Choi SH, Jeong JH, et al. Balance and Mobility Performance Along the Alzheimer’s Disease Spectrum. J Alzheimers Dis. 2020;73(2):633-644. doi: 10.3233/JAD-190601
  15. An R, Huang X, Zhang S, Gao Y, Li L, Wan Q. Can motor decline be a modifiable marker of clinical progression in subjective cognitive decline? A national prospective cohort study. Asian J Psychiatr. 2024;94:103978. doi: 10.1016/j.ajp.2024.103978
  16. Muhammad T, Srivastava S, Debnath P, Kumar P, Kumar M. Does tandem balance test predict cognitive impairment among older adults? Findings from Longitudinal Ageing Study in India, 2017-18. Aging Clin Exp Res. 2023;35(4):855-865. doi: 10.1007/s40520-023-02359-1
  17. Chantanachai T, Sturnieks DL, Lord SR, et al. Cognitive and physical declines and falls in older people with and without mild cognitive impairment: a 7-year longitudinal study. Int Psychogeriatr. 2024;36(4):306-316. doi: 10.1017/S1041610223000315
  18. Bosmans J, Gommeren H, Gilles A, et al. Evidence of Vestibular and Balance Dysfunction in Patients With Mild Cognitive Impairment and Alzheimer’s Disease. Ear Hear. 2024;45(1):53-61. doi: 10.1097/AUD.0000000000001401
  19. Melo LM, Ansai JH, Ferreira ACVG, et al. Correlation between changes in Timed Up and Go performance and cognition in older people with mild cognitive impairment: A longitudinal study. Clin Biomech. 2022;94:105620. doi: 10.1016/j.clinbiomech.2022.105620
  20. Naito T, Suzuki Y, Yamasue K, et al. Relationship between Cognitive Function and Sway of Body in Standing Posture: A Cross-Sectional Study. Geriatrics. 2023;8(2):29. doi: 10.3390/geriatrics8020029
  21. Kannan LN, Bhatt TS. Perturbation-based balance assessment: Examining reactive balance control in older adults with mild cognitive impairments. Physiol Int. 2021;108(3):353-370. doi: 10.1556/2060.2021.00181
  22. Bollinger RM, Chen SW, Krauss MJ, et al. The Association Between Postural Sway and Preclinical Alzheimer Disease Among Community-Dwelling Older Adults. J Gerontol A Biol Sci Med Sci. 2024;79(7):glae091. doi: 10.1093/gerona/glae091
  23. Ashiri M, Francisco C, Winkler J, Lithgow B, Moussavi Z. Postural Sway Characteristics Are Affected by Alzheimer’s Disease. Annu Int Conf IEEE Eng Med Biol Soc. 2021;2021:7219-7222. doi: 10.1109/EMBC46164.2021.9630746
  24. Caliskan H, Sahin UK, Baydan M, et al. Balance performance measured by posturography in mild-moderate Alzheimer’s Disease: An undervalued assessment. Geriatr Nurs. 2023;53:33-39. doi: 10.1016/j.gerinurse.2023.06.019
  25. So RJ, Biju K, Oh E, et al. Characterization of Balance Control and Postural Stability in Patients With Alzheimer Disease. Alzheimer Dis Assoc Disord. 2023;37(2):160-163. doi: 10.1097/WAD.0000000000000548
  26. Jamshed M, Shahzad A, Riaz F, Kim K. Exploring inertial sensor-based balance biomarkers for early detection of mild cognitive impairment. Sci Rep. 2024;14(1):9829. doi: 10.1038/s41598-024-59928-1
  27. Qi L, Zhou M, Mao M, Yang J. The static balance ability on soft and hard support surfaces in older adults with mild cognitive impairment. PLoS One. 2023;18(12):e0295569. doi: 10.1371/journal.pone.0295569
  28. Ahn S, Chung JW, Crouter SE, Lee JA, Lee CE, Anderson JG. Gait and/or balance disturbances associated with Alzheimer’s dementia among older adults with amnestic mild cognitive impairment: A longitudinal observational study. J Adv Nurs. 2023;79(12):4815-4827. doi: 10.1111/jan.15768
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Advanced Neurology, Electronic ISSN: 2810-9619 Print ISSN: 3060-8589, Published by AccScience Publishing