Background: Persistent dizziness without a clear cause is common in older adults. We
explored whether an anxiety-driven preoccupation with consciously processing balance may
underpin the distorted perceptions of unsteadiness that characterises ‘unexplained’ dizziness
in older adults.
Methods: We experimentally induced anxiety about ...
Background: Persistent dizziness without a clear cause is common in older adults. We
explored whether an anxiety-driven preoccupation with consciously processing balance may
underpin the distorted perceptions of unsteadiness that characterises ‘unexplained’ dizziness
in older adults.
Methods: We experimentally induced anxiety about losing one’s balance (through a
postural threat manipulation) in a cohort of asymptomatic older adults and evaluated
associated changes in perceived stability, conscious movement processing and postural
control. These outcomes were also assessed when performing a distracting cognitive task
designed to prevent anxiety-related conscious movement processing, in addition to during
baseline conditions (ground level).
Results: Despite a lack of increase in postural sway amplitude (p = .316), participants
reported reductions in perceived stability during postural threat compared to baseline (p <
.001). A multiple linear regression revealed that anxiety-related conscious movement
processing independently predicted perceptions of instability during this condition (p = .006).
These changes were accompanied by alterations in postural control previously associated
with functional dizziness, namely high-frequency postural sway and disrupted interaction
between open- and closed-loop postural control (ps < .014). While the distraction task
successfully reduced conscious processing (p = .012), leading to greater perceived stability (p
= .010), further increases in both postural sway frequency (p = .002) and dominance of
closed-loop control (p = .029) were observed.
Conclusions: These findings implicate the role of conscious movement processing in
the formation of distorted perceptions of unsteadiness, suggesting that such perceptions may
be modifiable by reducing an over-reliance on conscious processes to regulate balance.