Individuals with dementia with lewy bodies exhibit worsened reactive walking balance responses to treadmill-induced perturbations than matched controls.

BACKGROUND: Dementia with Lewy Bodies (DLB) significantly increases older adults' risk of falling far more than other forms of dementia. This increased falls risk may be attributed to worse proactive balance adjustments due to reduced cognitive functioning and/or worse reactive responses due to symptoms such as parkinsonism. However, no studies have deployed balance perturbations in individuals with DLB to interrogate their balance integrity.

METHODS: This study aimed to (1) determine the feasibility of deploying walking balance perturbations in individuals with DLB and (2) quantify differences in proactive adjustments and reactive responses between individuals with DLB (n = 20) and age- and BMI-matched controls (n = 20). We calculated whole-body angular momentum (WBAM) before, during, and after anticipated and unanticipated treadmill belt accelerations and decelerations in a subset of participants (11 DLB, 11 Controls).

RESULTS: The DLB group demonstrated a 78% perturbation completion rate, suggesting it is feasible to deploy perturbations in individuals with DLB while considering for comorbidities. In partial contrast to our hypothesis, we found that the DLB group did not exhibit worse proactive adjustments than controls; in support of our hypothesis, the DLB group required larger reactive responses than controls, which we interpret to suggest worse reactive balance control.

CONCLUSIONS: These results have potential to inform the feasibility of future studies investigating balance in individuals with DLB and designing interventions to improve balance control in these individuals, thereby reducing their risk of falling.