Application of functional near-infrared spectroscopy in older adults with balance impairment: A review

As the population ages, the issue of falls among the elderly is becoming increasingly prominent, and balance dysfunction is one of the main risk factors for falls. Accurately assessing balance function in older adults and elucidating its underlying neural mechanisms holds significant clinical importance for predicting fall risk and developing personalized interventions. In recent years, functional near-infrared spectroscopy (fNIRS), as a non-invasive brain imaging technology, has demonstrated unique advantages in revealing the neural mechanisms underlying balance control, owing to its good portability, relative tolerance to motion artifacts, and high ecological validity. The purpose of this article is to introduce the principles of fNIRS technology, explore the age-related changes in the neurophysiological mechanisms of balance control through the lens of the Scaffolding Theory of Aging and Cognition (STAC), summarize key findings from studies applying fNIRS to common balance-related disorders in older adults, and analyze current limitations and future translational research directions.