A condition that commonly increases with age, small vessel disease occurs due to microangiopathy of arterioles in the brain, making these arteries less flexible, thereby potentially interfering with blood flow. As a result, loss of motor coordination, including balance, as well as cognitive impairment may occur. Yasuharu Tabara, from Kyoto University Graduate School of Medicine (Japan), and colleagues assessed 841 women and 546 men, average age of 67 years, for the ability to stand on one leg (eyes open). Subjects performed this examination twice and the better of the two times was used in the study analysis. Cerebral small vessel disease – small infarctions without symptoms such as lacunar infarction and microbleeds, was evaluated using brain magnetic resonance imaging. Researchers found that the inability to balance on one leg for longer than 20 seconds was associated with cerebral small vessel disease. As well, the team observed that 34.5% of those with more than two lacunar infarction lesions had trouble balancing; 16% of those with one lacunar infarction lesion had trouble balancing; 30% of those with more than two microbleed lesions had trouble balancing; and 15.3^ with one microbleed lesion had trouble balancing. The study authors conclude that: “Postural instability was found to be associated with early pathological changes in the brain and functional decline, even in apparently healthy subjects.”
Tabara Y, Okada Y, Ohara M, Uetani E, Kido T, Ochi N, Nagai T, Igase M, Miki T, Matsuda F, Kohara K. “Association of postural instability with asymptomatic cerebrovascular damage and cognitive decline: the Japan shimanami health promoting program study.” Stroke. 2015 Jan;46(1):16-22.