Effective integration of concurrent sensory information is crucial for successful locomotion. This study aimed to determine the association of multisensory integration with mobility outcomes in aging. A total of 289 healthy older adults (mean age 76.67 ± 6.37 years; 53% female participants) participated in a visual–somatosensory simple reaction time task. Magnitude of multisensory effects was assessed using probability models, and then categorized into four multisensory integration classifications (superior, good, poor, or deficient). Associations of multisensory integration with falls and balance (unipedal stance) were tested at cross-section and longitudinally using Cox proportional hazards models. At baseline, the prevalence of falls in the previous year was 24%, and 52% reported an incident fall over a mean follow-up period of 24 ± 17 months. Mean unipedal stance time was 15 ± 11 seconds. Magnitude of multisensory integration was a strong predictor of balance performance at cross-section (β = 0.11; p < .05). Of the cohort, 31% had superior, 26% had good, 28% had poor, and 15% had deficient multisensory effects. Older adults with superior multisensory integration abilities were significantly less likely to report a fall in the past year (17%), compared to the rest of the cohort (28%; χ² = 4.01; p = .04). Magnitude of multisensory integration was an incremental predictor of incident falls (adjusted hazard ratio = 0.24; p = .01), over and above balance and other known fall risk factors. Our study highlights the clinical relevance of multisensory integration in aging; worse visual–somatosensory integration is associated with worse balance and increased risk of incident falls.

Research detailing multisensory integration (MSI) processes in aging and their association with clinically relevant outcomes is virtually non-existent. To our knowledge, the relationship between MSI and balance has not been well-established in aging. Given known alterations in unisensory processing with increasing age, the aims of the current study were to determine differential behavioral patterns of MSI in aging and investigate whether MSI was significantly associated with balance and fall-risk. Seventy healthy older adults ( years; 58% female) participated in the current study. Participants were instructed to make speeded responses to visual, somatosensory, and visual-somatosensory (VS) stimuli. Based on reaction times (RTs) to all stimuli, participants were classified into one of two groups (MSI or NO MSI), depending on their MSI RT benefit. Static balance was assessed using mean unipedal stance time. Overall, results revealed that RTs to VS stimuli were significantly shorter than those elicited to constituent unisensory conditions. Further, the current experimental design afforded differential patterns of multisensory processing, with 75% of the elderly sample demonstrating multisensory enhancements. Interestingly, 25% of older adults did not demonstrate multisensory RT facilitation; a finding that was attributed to extremely fast RTs overall and specifically in response to somatosensory inputs. Individuals in the NO MSI group maintained significantly better unipedal stance times and reported less falls, compared to elders in the MSI group. This study reveals the existence of differential patterns of multisensory processing in aging, while describing the clinical translational value of MSI enhancements in predicting balance and falls risk.

Deficits in visual-somatosensory (VS) integration are linked to poor mobility. Given that sensory, motor, and cognitive processes rely on overlapping neural circuitry that are compromised in dementia and pre-dementia stages like mild cognitive impairment (MCI), we hypothesize that cognitive impairment will be associated with reduced VS integration, which will, in turn, impact the relation between VS integration and mobility. A total of 345 older adults (mean age 76.88 ± 6.45 years; 52% female) participated in the current study. Cognitive impairment was defined as presence of MCI or dementia. Magnitude of VS integration was quantified using probability models. All participants completed assessments of general cognition (Repeatable Battery for the Assessment of Neuropsychological Status; RBANS), quantitative gait, and balance (unipedal stance). The magnitude of VS integration was lower in the 40 individuals with MCI (p = .02) and 12 with dementia (p = .04), relative to the 293 individuals without cognitive impairment. In fully adjusted models, magnitude of VS integration was only a strong predictor of performance on attention-based tests of the RBANS (β = 0.161; p < .01), regardless of cognitive status. Results from mediation analyses, however, reveal that cognitive impairment causes variation in magnitude of VS integration, which in turn causes variation in unipedal stance 95% confidence interval (CI) (−0.265, −0.002) and spatial aspects of gait 95% CI (−0.087, −0.001). Cognitive impairment influences multisensory integration, which adversely impacts balance and gait performance in aging. Future studies should aim to uncover the precise neural circuitry involved in multisensory, cognitive, and mobility processes.

Background: The ability to integrate information across sensory modalities is an integral aspect of mobility. Yet, the association between visual-somatosensory (VS) integration and gait performance has not been well-established in aging. Methods: A total of 333 healthy older adults (mean age 76.53 ± 6.22; 53% female) participated in a visual-somatosensory simple reaction time task and underwent quantitative gait assessment using an instrumented walkway. Magnitude of VS integration was assessed using probability models, and then categorized into four integration classifications (superior, good, poor, or deficient). Associations of VS integration with three independent gait factors (Pace, Rhythm, and Variability derived by factor analysis method) were tested at cross-section using linear regression analyses. Given overlaps in neural circuitry necessary for both multisensory integration and goal-directed locomotion, we hypothesized that VS integration would be significantly associated with pace but not rhythm which is a more automatic process controlled mainly through brainstem and spinal networks. Results: In keeping with our hypothesis, magnitude of VS integration was a strong predictor of pace (β = 0.12, p < 0.05) but not rhythm (β = −0.01, p = 0.83) in fully-adjusted models. While there was a trend for the association of magnitude of VS integration with variability (β = −0.11, p = 0.051), post-hoc testing of individual gait variables that loaded highest on the variability factor revealed that stride length variability (β = −0.13, p = 0.03) and not swing time variability (β = −0.08, p = 0.15) was significantly associated with magnitude of VS integration. Of the cohort, 29% had superior, 26% had good, 29% had poor, and 16% had deficient VS integration effects. Conclusions: Worse VS integration in aging is associated with worse spatial but not temporal aspects of gait performance.