I P Pavlov Russian Medical Biological Herald · Sep 30, 2026
Impact of age-dependent cognitive impairment on postural regulation in older age individuals and their prevention: a systematic review
By Pakhomov NV, Kostyunina DS, Artemenkov AA
BACKGROUND: As life expectancy increases, the incidence of age-related diseases is growing. Specifically, the incidence of dementia is rising alongside a decline in cognitive function. Furthermore, postural balance regulation degrades with age, increasing the risk of falls and injuries. A link has been found between imbalance and cognitive decline. One way to attenuate these age-related declines is through lifestyle modification, including physical exercise. AIM: To analyze and systematize the relationship between balance impairment and dementia in older adults and to outline strategies for preventing age-related deviations through physical exercise. A literature search was conducted in the PubMed database using the keywords 'aging', 'cognitive impairment', 'postural regulation', 'elderly', 'physical activity', and also in the scientific electronic database eLibrary.ru using the Russian keywords: 'постуральная регуляция', 'старение', 'когнитивные нарушения', 'физическая активность', 'равновесие'. The initial search yielded 837 papers on the association between cognitive impairment and/or dementia and physical activity, and 79 articles on the interconnection between aging, vestibular dysfunctions, and cognitive decline. Papers on Parkinson's disease, trauma, infectious and oncological diseases, diet, the influence of micro-, macro-elements and dietary supplements on cognitive functions, and preprints were excluded. The final analysis included 95 papers, 85 of which were published between 2015 and 2024, including 21 meta-analyses/systematic reviews, 32 clinical studies and 9 clinical trials. The review analyzes the relationship between postural instability, mild cognitive impairment and dementia in older adults, including possible mechanisms of postural instability in aging and their relationship with cognitive dysfunction. Particular attention is paid to comorbid conditions common in patients with vestibulopathies, such as stress, social isolation, sleep disturbances, and anxiety. Strategies for preventing age-related declines through pharmacotherapy and physical activity are presented, which can reduce the risk of falls and subsequent injuries in older adults, especially those with dementia. CONCLUSION: Aging increases the risk of dementia and cognitive impairment. Postural control declines with age and the incidence of falls increases. Pharmacotherapy and regular physical activity can significantly improve balance and cognitive function, leading to a reduction in the incidence of falls.