Analysis of Choice Stepping with Visual Interference Can Detect Prolonged Postural Preparation in Older Adults with Mild Cognitive Impairment at High Risk of Falling.

BACKGROUND/AIMS: We aimed to clarify postural control deficits in older adults with mild cognitive impairment (MCI) at high risk of falling by addressing the inhibitory process. METHODS: This study involved 376 community-dwelling older adults with MCI. Participants were instructed to execute forward stepping on the side indicated by the central arrow while ignoring the 2 flanking arrows on each side (→→→→→, congruent, or →→←→→, incongruent). Initial weight transfer direction errors [anticipatory postural adjustment (APA) errors], step execution times, and divided phases (reaction, APA, and swing phases) were measured from vertical force data. Participants were categorized as fallers (n = 37) and non-fallers (n = 339) based on fall experiences in the last 12 months. RESULTS: There were no differences in the step execution times, swing phases, step error rates, and APA error rates between groups, but fallers had a significantly longer APA phase relative to non-fallers in trials of the incongruent condition with APA errors (p = 0.005). Fallers also had a longer reaction phase in trials with the correct APA, regardless of the condition (p = 0.01). CONCLUSION: Analyses of choice stepping with visual interference can detect prolonged postural preparation as a specific falling-associated deficit in older adults with MCI.