Prevalence of Perceptual Dysfunction in Geriatric Population

Abstract

BACKGROUND - Aging is a natural term that involves alterations to numerous systems of the body including the sensorimotor system that is utilized for postural control, balance and coordinated movement while in motion. Proprioception involves an unconscious appraisal of the body within space and movement. Proprioception is processed by many different receptors within our muscles, tendons and joints. With aging come both structural and neurologic changes that relate to proprioception and sensorimotor function. Examples include decreased sensitivity to mechanoreceptors, slower nerve conduction and decreased processing speed in the central nervous system. Additionally, comorbidities such as osteoarthritis, diabetes and having a stroke may lead to perceptual problems for older adults. Lifestyle factors including decreased levels of physical activity (especially perceived forms of physical activity) exacerbate perceptual dysfunction. Therefore, it is common amongst many older adults to exhibit mobility problems, have difficulty maintaining balance and increased likelihood of falling which can result in injury, loss of autonomy and lower quality of life. Despite proprioception being an important factor of interacting with an environment, proprioceptive dysfunction is rarely assessed or reported in geriatric assessments. There is a need for more research in older adults to demonstrate the presence of proprioceptive dysfunction, and provide support for prevention strategies and physiotherapy rehabilitation interventions that promote healthy aging and successful aging.

OBJECTIVE-

1. To study the prevalence of perceptual dysfunction in geriatric population.
2. To identify the risk factors for perceptual dysfunction in geriatric population.
3. To identify types of perceptual dysfunction those most commonly experiencing by older adult
4. To Identify Early Signs and Indicator for the joint perception dysfunction

MATERIAL AND METHODOLGY- institutional protocol and ethical committee approval, vide their letter no. KVV/ IEC/01/2025 dated January 23, 2025. This cross-sectional study was conducted on 95 elderly individuals aged 65 years and older from Satara district using simple random sampling. Study participants were recruited that had no serious medical, neurological or psychiatric comorbidities based on their age. Participants were also excluded for inability to provide informed consent, severe sensory impairment, joint surgery in the previous 3 months, drug or alcohol dependency. Data collection utilized a validated questionnaire and two clinical tests. Proprioception was performed with the clinician passively moving one of the participant's limbs and asking the participant to match the position with the opposite limb, and kinesthesia was performed by moving a joint on the participant and asking participants to indicate when they sensed movement to which they indicated by recording the point of movement. While proprioception and kinesthesia were each conducted with eyes open and eyes closed. All trials were recorded, tabulated, and analyzed statistical in order to understand the prevalence of perceptual dysfunction amongst the elderly individual.

RESULT- This study indicated that 95 participants displayed variability when required to determine the position of their joints which implies a general decline in proprioception with older adults. Over-all there was a prevalence of joint position impairments of 10.13% with more dysfunction evident in eyes-closed than eyes-opened testing which indicates reliance on vision. The joint with the most impact was the ankle because 55% of older adults had decreased ability to align to the previous position, with the lower segments (ankle, knee, and hip) affected more than the upper (shoulder, elbow, and wrist) segments. No falls or balance difficulties were reported, although falls and balance difficulties are excellent global markers of early sensory loss and should be noted for further specific assessment and intervention with regard to lower limb stability and fall prevention.

CONCLUSION- This study found that perceptual dysfunction occurred in a sample of 10.13% of geriatric population. This finding suggests that older adults rely considerably more on vision to compensate for a reduction in joint awareness, given that the most marked perceptual dysfunction occurred during eyes-closed testing. The ankle was the joint most affected by degenerative perceptual dysfunction and the lower limb demonstrated more perceptual dysfunction than the upper limb. This finding is particularly relevant, as weight-bearing joints rely very much upon occur typical ability to balance. Since participants did not report any falls or challenges to their balance, having measurable perceptual dysfunction is an early sensorineural decline and can progress toward, for example, more substantive mobility problems. While perceptual impairment is ubiquitous among geriatric counterparts, it should not be a part of experience for older adults, and for the clinical sector any perceptual dysfunction should be easily used for documentation. Regularly assessing proprioceptive screening, particularly for high-risk joints, and providing physiotherapy intervention when perceptual dysfunction is documented has the potential to reduce (not eradicate) the incidence of falls in older adults while maximally preserving independence and quality of life