Sensory integration during balance in individuals with differing degrees of Senile Dementia of the Alzheimer's Type Public Deposited

http://ir.library.oregonstate.edu/concern/graduate_thesis_or_dissertations/fj236532h

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  • Individuals with Senile Dementia of the Alzheimer Type (SDAT) are up to four times more likely to sustain an accidental fall than their non-demented peers. The cause(s) of this elevated risk, however, has not been determined. Prior to the design of balance retraining programs, researchers need to uncover the nature of the elevated risk in these individuals. To address this need, the present investigation compared postural stability in altered sensory environments both between individuals with mild-SDAT and moderate-SDAT, and to a group of apparently healthy older adults (HOA) (N = 6, 6, & 10, respectively), using the Sensory Organization Test@ (SOT). Measures of percent equilibrium (%EQ) and movement velocity (MV) were used to assess postural stability for the six sensory conditions. It was hypothesized, based on neural impairment patterns associated with SDAT, that postural stability would decrease as a function of disease severity when sensory information was inaccurate or absent. The results of this study, however, failed to support this hypothesis, in that the moderate-SDAT group performed more like the HOA than the mild-SDAT group. Significant differences in %EQ(p < .008) were found between the mild-SDAT group and both the HOA and moderate-SDAT groups in the absence of vision and when the vestibular system was the primary source of accurate positional information. Significant differences were also evident between the HOA group and the mild-SDAT group when the environment was unaltered and when vision was inaccurate. No significant differences were evident for the measure of MV; however, moderate to large effect sizes were obtained for both %EQand MV for a number of the sensory conditions between the three groups. These results suggest that individuals become less visually dependent in the later stages of the illness, possibly due to the increased frequency of visual disturbances associated with disease progression. To compensate for these disturbances individuals may shift from being visually dependent to relying more on somatosensory and vestibular inputs for the control of upright balance. Future longitudinal research is needed to determine if the shift away from vision as the preferred sensory system is causally related to disease progression.
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