Orthostatic tremor: a cause of postural instability in the elderly

Abstract Introduction Postural instability problem in the elderly is associated the cognitive impairment. The ageing process is directly linked to impairments in postural stability. Dual task activity is a commonplace to most activities of daily living. The elderly who has a postural instability and cognitive decline that are mechanisms which lead to an increased risk of falls in the elderly. Objective To investigate the effect of dual task training on postural stability in the healthy elderly. Methods The sixty-six healthy elderly were selected based on the inclusion criteria. With randomized 33 participants in each experimental and control group. The experimental group received dual task training for 6 weeks delivered three days per week. The control group received education for postural stability and aerobic exercise. Their postural stability was assessed using the Mini-BESTest in before and after training. Results The score of the Mini-BESTest compare between before and after 6 weeks were significantly different in postural stability and cognitive from that before in experimental group (p<0.001). Conclusions The finding support the dual task training program can improve postural stability in the elderly. Therefore, the dual task training program should be implemented with the elderly to be a choice of exercises for the elderly with postural instability.

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Comorbid Normal Pressure Hydrocephalus with Parkinsonism: A Clinical Challenge and Call for Awareness

Case Reports in Neurological Medicine ◽

10.1155/2018/2513474 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8

Author(s):

A. Cucca ◽

M. C. Biagioni ◽

K. Sharma ◽

J. Golomb ◽

R. M. Gilbert ◽

...

Keyword(s):

Clinical Features ◽

Normal Pressure Hydrocephalus ◽

Normal Pressure ◽

The Elderly ◽

Postural Instability ◽

Concomitant Disease ◽

Clinical Challenge ◽

Neurologic Disorders ◽

Insidious Onset ◽

Gait Dysfunction

Idiopathic normal pressure hydrocephalus (iNPH) is the most common cause of hydrocephalus in adults. The diagnosis may be challenging, requiring collaborative efforts between different specialists. According to the International Society for Hydrocephalus and Cerebrospinal Fluid Disorders, iNPH should be considered in the differential of any unexplained gait failure with insidious onset. Recognizing iNPH can be even more difficult in the presence of comorbid neurologic disorders. Among these, idiopathic Parkinson’s disease (PD) is one of the major neurologic causes of gait dysfunction in the elderly. Both conditions have their peak prevalence between the 6th and the 7th decade. Importantly, postural instability and gait dysfunction are core clinical features in both iNPH and PD. Therefore, diagnosing iNPH where diagnostic criteria of PD have been met represents an additional clinical challenge. Here, we report a patient with parkinsonism initially consistent with PD who subsequently displayed rapidly progressive postural instability and gait dysfunction leading to the diagnosis of concomitant iNPH. In the following sections, we will review the clinical features of iNPH, as well as the overlapping and discriminating features when degenerative parkinsonism is in the differential diagnosis. Understanding and recognizing the potential for concomitant disease are critical when treating both conditions.

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