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Abstract

Postural instability is one of the most common causes of dependence, reduced quality of life, and falls, the leading cause of injury and subsequent death for older adults. Older adults with cognitive impairment are at an increased risk of postural instability and falls due to decreased neural control. Although quantitative postural sway measures have been used to assess postural instability, postural sway in older adults with mild cognitive impairment (MCI) has yet to be measured frequently across time. Inspired by other longitudinal studies conducted within the framework of OHSU?s Oregon Center for Aging and Technology (ORCATECH), we integrated a Nintendo Wii balance board and a tablet into ORCATECH?s current in-home technological platform to extract daily measures of postural sway with and without cognitive loading in older adults with and without MCI. This dissertation reveals associations between frequent postural sway measures and cognitive functioning, assesses the feasibility of in-home monitoring of postural sway in older adults with MCI, and lays the foundation for large-scale, long-term implementation. Tracking longitudinal changes in postural sway may further our understanding of early-stage postural decline and its association with cognitive decline and may aid in preclinical detection of dementia and fall risk.

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