Science of Falling

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How Balance and Fall Risk Impact Cognitive Health: Reducing Dementia Risk Through Movement

Brent Pritt

Essential Points:

  • Balance and Cognitive Health Are Linked: Improving your balance doesn’t just prevent falls—it also helps preserve cognitive function by stimulating brain areas involved in movement and decision-making, potentially reducing the risk of dementia.

  • Falls and Cognitive Decline Feed Into Each Other: Cognitive impairments like dementia increase fall risk, while falls (especially those causing head injuries) can accelerate cognitive decline, creating a harmful cycle that can be broken with targeted prevention strategies.

  • Balance Training Supports Both Body and Brain: Regular balance exercises, including dual-tasking activities, not only improve physical stability but also enhance cognitive function, making it a powerful tool for both fall prevention and brain health.

As we get older, it’s natural to think more about staying physically strong, balanced, and active. But what if I told you that improving your balance doesn’t just keep you on your feet, it can also help keep your mind sharp? In this article, we’re going to dive deep into how balance, fall risk, and cognitive function are closely linked, and why working on your balance could even help reduce the risk of dementia.

Understanding the Link Between Balance and Cognitive Function

Your balance isn’t just about standing on one foot or staying steady as you walk. It’s actually a complex process that involves both your body and your brain. Your ability to balance is controlled by multiple systems, including:

  • The Three Bodily Balance Systems:

    • The Vestibular System: Located in the inner ear, this system helps you sense where your head is in space.

    • The Visual System: Your eyes ability to see and take in information from the surrounding environment.

    • The Proprioceptive System: Defined by your ability to feel the ground and adjust your body based off of information in your joints.

  • The Musculoskeletal System: Your muscles and joints work together to adjust your position and keep you stable.

  • The Nervous System: Made up of your brain and nerves. This system controls everything including your cognitive functions, like decision-making, reaction time, and even memory, which all play a crucial role in keeping you steady.

This is where things get interesting. Research shows that problems with cognitive function, especially in areas like executive function (the brain’s ability to plan, organize, and manage time), can directly affect your ability to balance. (1, 2, 3) Think about it this way, if your brain can’t quickly process information about your environment or send instant signals to your muscles, you’re more likely to trip or fall.

Cognitive Impairment Increases Fall Risk

Studies show that individuals with cognitive impairments, such as dementia, Alzheimer’s or mild cognitive decline, are at a much higher risk of falling. (3, 4) In fact, cognitive decline and poor balance often go hand in hand.

Why?

Dementia affects parts of the brain responsible for attention and motor control. (5) This means that those who struggle with cognitive issues may have difficulty reacting quickly to hazards like uneven surfaces, obstacles, or even changes in walking speed. Sometimes, there isn’t even a reaction at all as the brain just cannot recognize a dangerous situation. This is why some people with dementia appear to be very impulsive. Their brain simply has no significant guard rails up for self-preservation.

This connection between brain health and balance becomes particularly evident when looking at early-stage dementia. (6) These individuals may not just struggle with memory loss, but also experience decreased mobility and slower reaction times, all of which increase the risk of falls.

How Falls Increase the Risk of Dementia

Now, let’s flip the script, how does falling affect your brain? Falling doesn’t just pose a physical risk; it can actually have a long-term impact on your cognitive health.

Traumatic Brain Injuries and Dementia Risk

Falls are the number one cause of traumatic brain injuries (TBIs) in older adults. (7) Even a mild TBI, like a concussion, can double your risk of developing dementia, with more severe TBIs increase the likelihood even further. (8) When a fall causes a head injury, the brain may suffer from long-term damage that accelerates neurodegeneration (breakdown of brain connections and systems), the process that leads to dementia.

What’s even more concerning is that many people don’t realize how even a seemingly small head injury can have lasting effects on their cognitive health. For older adults, any fall that involves a blow to the head should be taken seriously.

Physical Inactivity After Falls

Another way falls contribute to cognitive decline is through inactivity. (9) After a fall, many older adults become less active due to fear of falling again or simply recovering from injury. This reduction in physical activity leads to a decline in both physical and cognitive health. Sitting or being fairly sedentary for 10 hours or more per day can increase the risk of dementia by a significant amount in the long term.

We know that physical activity is critical for your brain health. (10) Exercise stimulates blood flow to your brain, promotes neuroplasticity (the brain’s ability to form new connections), and even helps delay the onset of Alzheimer’s disease. When older adults reduce their activity levels out of fear or injury, they increase their risk of developing cognitive problems down the road.

Can Balance Training Help Reduce the Risk of Cognitive Decline?

The short answer is yes. Balance training can actually play a significant role in preserving your cognitive function. Let’s break down how.

The Brain Benefits of Balance Training

Balance exercises stimulate parts of your brain that control both your movement and cognition. (11, 12) By challenging your body to maintain stability, you’re also challenging your brain to process information and make decisions quickly. This promotes neuroplasticity, which is your brain’s ability to form and strengthen neural connections.

A study found that balance exercises not only improve physical stability but also enhance executive function, which includes skills like problem-solving, planning, and decision-making. (13) These are the same cognitive abilities that tend to decline early in conditions like Alzheimer’s.

Another benefit of balance training is that it increases blood flow to your brain. (14) This improved circulation nourishes brain cells and helps delay cognitive decline, especially in cases such as vascular dementia, which is caused by reduced blood flow to the brain. (15)

Dual-Tasking for Better Brain Health

One particularly effective type of balance training involves dual-tasking. This means performing cognitive tasks, like counting backward or naming animals, while you’re doing a balance exercise such as standing on one leg. Research has shown that combining balance training with mental challenges can improve both your physical and cognitive health, particularly in older adults. (12)

Dual-tasking mimics real-life situations where you need to multitask, like walking while talking or navigating a busy street. Training your brain to handle these tasks improves your reaction time, focus, and decision-making, all of which contribute to both better balance and sharper cognitive function.

Memory and Balance

There’s also evidence that balance training improves your memory. (11, 12) Certain exercises, such as tai chi, not only help with your balance but also enhance your memory and spatial awareness. (16, 17) This could be because balance control and memory both rely on the brain’s ability to integrate and process spatial information, thus strengthening those brain connections.

Reduced Risk of Injury

As mentioned previously, falling is the number one cause of TBI in older adults. By simply improving your balance, and balance related reaction time, you can prevent future falls. (18, 19) This means less overall risk for head injury and secondary TBI.

Gait and Mobility as Predictors of Cognitive Decline

Your gait, the way you walk, can reveal a lot about your brain health. Research has shown that slower gait speeds are often linked to cognitive decline. (20, 21) If you’re walking more slowly than you used to, it could be an early sign of problems with memory, attention, or executive function.

This makes your gait speed an important predictor of both fall risk and cognitive health. In fact, healthcare providers are increasingly using gait and mobility assessments to identify early signs of dementia and other cognitive disorders. (22) Assessing both physical and cognitive functions provides a fuller picture of someone’s overall health.

But speed isn’t the only thing healthcare providers look at, because your quality of gait matters as well. (23, 24) If you tend to walk with a limp, wide set feet, veer side-to-side, or hold onto furniture while you walk you most likely have balance issues. That means increased risk of falling, and an increased risking of hitting your head.

Fall Prevention and Cognitive Training Programs

So, how do you prevent falls while also supporting cognitive health? The key is to combine physical exercise with cognitive challenges.

The Role of Physical Exercise

Physical activity, especially balance and strength training, plays a crucial role in preventing falls and maintaining cognitive health. (25, 26) A well-rounded exercise program that includes:

  • Balance training to improve stability and coordination

  • Strength training to maintain muscle mass and reduce fall risk

  • Aerobic exercise to enhance cardiovascular health and increase blood flow to the brain

This type of well rounded program helps reduce the risk of falls and can slow cognitive decline.

Cognitive Training for Fall Prevention

Cognitive training may be just as important as physical exercise when it comes to fall prevention, although some studies have found conflicting information about how much cognitive training directly affects balance. (27, 28, 29, 30) By engaging in brain exercises like puzzles, learning a new language, or learning new skills, you can keep your mind sharp and potentially improve your ability to react quickly to physical challenges. While the jury is still out on what types of cognitive training will most help you in regards to fall prevention directly, the research supports engaging in difficult mental tasks to keep your brain sharp compared to your peers. (31) Simply keeping your brain as active and healthy as possible can help you make better decisions, and reduce overall risky behaviors that can sometimes come paired with cognitive decline.

Combining cognitive training with physical exercise creates a powerful program that promotes both brain and body health. Many fall prevention programs now include dual-tasking exercises to help older adults stay mentally and physically strong.

Final Thoughts: Why Balance Training is Key to Healthy Aging

The connection between balance, fall risk, and cognitive health is clear, improving your balance isn’t just about avoiding falls. It’s also about keeping your brain sharp, reducing the risk of cognitive decline, and staying mentally agile as you can keep doing the activities you love.

So, what’s the next step?

Start incorporating balance exercises into your daily routine. Whether it’s through tai chi, yoga, simple balance drills, or my Beginner to Intermediate Balance Program, improving your stability can have a huge impact on both your physical and cognitive health.

Are you ready to improve your balance and protect your brain health? Start today by adding a few balance exercises to your routine. And if you want personalized guidance, check out my 90-Day Age Strong Blueprint coaching package. A complete 3-4 month coaching experience that is a crash course in being your best healthy self. It will be the last coaching program for health you’ll ever need. Remember, investing in your balance and health now means a healthier, sharper future!

References

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