Balance and mobility in geriatric patients: Assessment and treatment of neurological aspects

Klaus Jahn*, Ellen Freiberger, Bjoern M. Eskofier, Cornelius Bollheimer, Jochen Klucken

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

16 Citations (Scopus)


Background: Personal autonomy in advanced age critically depends on mobility in the environment. Geriatric patients are often not able to walk safely with sufficient velocity. In many cases, multiple factors contribute to the deficit. Diagnostic identification of single components enables a specific treatment. Objective: This article describes the most common neurological causes of imbalance and impaired gait that are relevant for a pragmatic approach for the assessment of deficits in clinical and natural environments taking into account the physiology of balance and gait control, typical morbidities in older people and the potential of innovative assessment technologies. Material and methods: Expert opinion based on a narrative review of the literature and with reference to selected research topics. Results and discussion: Common neurological causes of impaired balance and mobility are sensory deficits (reduced vision, peripheral neuropathy, vestibulopathy), neurodegeneration in disorders with an impact on movement control and motoric functions (Parkinsonian syndromes, cerebellar ataxia, vascular encephalopathy) and functional (psychogenic) disorders, particularly a fear of falling. Clinical tests and scores in laboratory environments are complemented by the assessment in the natural environment. Wearable sensors, mobile smartphone-based assessment of symptoms and functions and adopted strategies for analysis are currently emerging. Use of these data enables a personalized treatment. Furthermore, sensor-based assessment ensures that effects are measured objectively.

Original languageEnglish
Pages (from-to)316-323
Number of pages8
JournalZeitschrift fur Gerontologie und Geriatrie
Issue number4
Publication statusPublished - 1 Jul 2019
Externally publishedYes


  • Dizziness
  • Falls
  • Gait disorder
  • Postural control
  • Vertigo


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