Are Static and Dynamic Balance Tests A Criteria Showing Cognitive Impairments In the Elderly?

The mini mental test is a test that can be administered by a physician, nurse, psychologist or a healthcare professional with a short training. It is a practical mental test in terms of applicability that can show the cognitive level globally. Evaluates cognitive performance quantitatively. It is important in terms of examining the course of dementia cases and their response to treatment in the clinic. There are 11 items in the test gathered around 5 main headings. These items are; Orientation is register memory, attention and calculation, recall and language. The total score is evaluated out of 30. A score of 25 and above is considered normal. Between 10 and 19 is moderate dementia. Between 19-24 refers to early dementia (13,14).

The test clinically assesses the ability to change direction while taking a step. At the start of the test, the patient stands in the upper left square (Frame 1) and looks in the direction of Square 2. First, the step sequence is clockwise: Square 1, then Squares 2, 4, and 3. Then the step sequence is counterclockwise: square 3, followed by squares 4, 2, and 1. The physiotherapist demonstrates the test and allows the patient to apply the model to learn the sequence. The test is repeated if the patient fails to complete the sequence successfully or loses balance or touches the cane. Two points are obtained and the better of these two points is recorded. Timed effort begins when the first foot touches the ground at Square 2 and then ends when the patient's second foot touches the ground at Square 1 (15, 16, 17).

The test assesses functional mobility, balance, and performance in adults 65 years and older. Wearing normal shoes and walking aids, the patient begins the test in a standard seat with his back against the chair, his arms resting on the arms of the chair, and both feet flat on the floor. The patient is instructed to stand up and walk to a line on the ground at a distance of 3 m, turn on the line, walk back to the chair and sit on the chair. The test ends when the patient's hip touches the seat.

The test is repeated twice; The fastest time is recorded. It is classified as mobile for <10 s, general independent for <20 s, and limited mobility for >30 s (15, 16, 18).

One leg is lifted without touching the standing leg. Initially, the eyes remain open. The patient is instructed to close their eyes and is asked to maintain their balance for 30 seconds. Balance disorder is suspected if the lifted leg touches the support leg, the lifted leg touches the ground, the patient jumps on the standing leg, or touches something for balance. Inability to balance on one leg for 30 seconds during one-leg stance is an indication of decreased balance function. However, the clinical expectation for the ability to balance on one leg decreases with the age of the patient. Healthy individuals aged 60-69 should be able to stand on one leg with their eyes open for at least 5 seconds (19).

The functional reach test, developed by Duncan et al., is a reliable and validated test used in clinical balance measurement. Have the patient raise the right arm 90° while standing in a comfortable position with bare feet and then step with the right arm without stepping and/his balance. During the functional reach test, the physiotherapist observes whether the patient is on the ground with both feet and does not step forward. If one of these behaviors occurs, the patient repeats the test. The Functional Reach Test is repeated three times and the best measurement is recorded. Decreased ability to lie down indicates an increased risk of the patient falling in the future; Values of 15 cm and below indicate a significantly increased risk of falling, and values between 15 and 25 cm indicate a mild fall risk (20).