ABS 035: The Impact of Executive Dysfunction on Brain Activity During Postural Control in Older Adults

Serene Alshalabi ¹ , Brad Manor ² , Melike Kahya ¹

¹ High Point University, Department of Physical Therapy
² Harvard Medical School, Department of Medicine

Van Wickle (2025) Volume 1, ABS 035

Introduction: Executive functioning is critical for maintaining physical performance in older adults, yet its impact on brain activity during postural control, particularly under dual-task conditions, remains underexplored. This study examined the relationship between executive dysfunction and brain activity during postural control in older adults under both single-task and dual-task conditions. We hypothesized that older adults with executive dysfunction would exhibit reduced EEG alpha power, greater postural sway, and slower Timed Up and Go (TUG) times compared to healthy controls.

Methods: Nineteen participants (age: 73.0 ± 4.2, 13 female) without executive dysfunction and sixteen participants (age: 76.0 ± 7.0, 10 female) with executive dysfunction were recruited. Executive dysfunction was defined by a Trail Making Test B (TMT-B) completion time exceeding 90 seconds. Electroencephalogram (EEG) assessed brain activity, while APDM inertial sensors recorded postural sway metrics during single-task and dual-task standing conditions. The Timed Up and Go (TUG) test assessed mobility. Independent t-tests compared EEG alpha power, mobility, and postural sway outcomes between these groups.

Results: The results indicated that older adults with executive dysfunction had significantly lower alpha power compared to healthy older adults during single-task and dual-task standing conditions. Older adults with executive dysfunction also took significantly longer to complete the TUG test and exhibited greater postural sway area during single-task standing.

Discussion: These findings suggest that executive dysfunction in older adults is associated with decreased alpha power and impaired postural control. Screening for executive dysfunction using cognitive battery assessments, including TMT-B, may allow for early identification of individuals at risk. Rehabilitation strategies should prioritize dual-task training to improve attentional allocation during postural control. Additionally, EEG alpha power may serve as a potential biomarker for tracking cognitive-postural decline in older adults. Modulating alpha power through non-invasive brain stimulation may be a potential strategy to slow or prevent cognitive-postural decline. Further research is needed to investigate the neurophysiological mechanisms underlying these observed relationships.