Effects of age, sex, and sensory information on balance performance in young and older adults

Ahmad Ali Akbari Kamrani¹Amir Shams^2*Parvaneh Shamsipour³Robab Sahaf¹Mahdi Bayati^4*Hamed Abbasi⁵Urs Granacher⁶Lara Carneiro^7*

• ¹Department of Aging, Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
• ²Department of Motor Behavior, Sport Sciences Research Institute, Tehran, Iran
• ³Department of Motor Behavior, Faculty of Sport Science, Alzahra University, Tehran, Iran
• ⁴Department of Exercise Physiology, Sport Sciences Research Institute, Tehran, Iran
• ⁵Department of Sport Medicine, Sport Sciences Research Institute, Tehran, Iran
• ⁶Department of Sport and Sport Science, Exercise and Human Movement Science, University of Freiburg, Freiburg, Germany
• ⁷Physical Education Department, College of Education, United Arab Emirates University, Abu Dhabi, United Arab Emirates

Background: This study aimed to comprehensively investigate the independent and interactive effects of age, sex, and sensory information on balance control in young and older adults. Methods: A total of 250 participants, stratified into five age groups (25-40, 60-65, 66-70, 71-75, and 76-80 years) with equal sex distribution, underwent the Sensory Organization Test (SOT) using computerized dynamic posturography. Balance was assessed using center of pressure (COP) velocity and displacement across six sensory conditions that selectively challenged and altered the availability and reliability of visual, proprioceptive, and vestibular information, thereby eliciting adaptive multisensory reweighting rather than isolating individual sensory systems. A 5 (age group) × 2 (sex) × 6 (sensory condition) repeated-measures ANOVA was used for analysis. Results: The analysis revealed significant main effects of age group and sensory condition on both COP velocity and displacement (age group: p<0.001 for all; sensory condition: p<0.001 for all), with balance performance systematically declining with each successive age group and as sensory conditions became more challenging. No significant main sex effects were found. Critically, significant interactions revealed that the detrimental effects of age and sensory conditions were not uniform across all groups. Notably, the effect of challenging sensory conditions was more pronounced in older adults (age × condition, p<0.001, d=0.50). Furthermore, a significant age × sex interaction (p=0.001, d=0.59) indicated that sex differences emerged primarily in the oldest cohort (76-80 years), where females exhibited greater instability than males. Conclusion: Balance control is profoundly influenced by age and the availability of accurate sensory information, with older adults, especially the oldest old, demonstrating significantly greater impairment under sensory-challenging conditions. While sex alone was not a dominant factor, its interaction with age suggests that the oldest females may represent a particularly vulnerable subgroup.