Author(s): BIZZOZERO, S., BORGHI, S., IMPERIALI, L., BANFI, G., Institution: IRCCS ISTITUTO ORTOPEDICO GALEAZZI, MILAN, ITALY, Country: ITALY, Abstract-ID: 1270

INTRODUCTION:
Aging is associated with a decline in physical and cognitive functions, increasing fall risk, which represents a leading cause of injury and mortality in individuals over 60 with incidence reaching up to 42% after age 70. Beyond muscle weakness and balance impairment, other potentially relevant yet under‑explored contributors include reduced visual attention (VA), prolonged response time (RT), and sleep disturbances. This study primarily investigates the association between Virtual Reality (VR)‑based measures of VA and RT and indicators of fall risk in older adults, while also considering sleep, nutritional status, balance, and muscle strength as additional contributing factors.
METHODS:
In this preliminary analysis, 21 adults (F=12; M=9) over 60 years of age were recruited at IRCCS Ospedale Galeazzi–Sant’Ambrogio and enrolled as part of a larger cross‑sectional observational project, approved by the local Ethics Committee and registered on ClinicalTrials.gov (NCT06940245). Participants underwent cognitive assessment of VA and RT in immersive VR using a software developed by Mind Room Lab. Muscle function was evaluated through handgrip strength (K-Grip, KINVENT) and maximal isometric knee extensor and flexor strength measured with a digital dynamometer (K-Push, KINVENT), while balance was assessed with the Baiobit system (BTS Bioengineering). All the participant also performed the 30s Chair Stand Test (30s-CST). Sleep was monitored for seven days using wrist actigraphy (MotionWatch 8, CamNTech) combined with daily sleep diaries.
RESULTS:
Males showed higher values than females in all maximal strength tests (handgrip strength: p < 0.001; knee extensor strength: p = 0.002; knee flexor strength: p = 0.009). Males also registered higher VA scores and faster RTs in the VR assessments, although these differences did not reach statistical significance. No significant sex differences were found in the unipedal balance test. Regarding sleep, females demonstrated better sleep efficiency (p = 0.007) and lower wake after sleep onset (p = 0.010) compared with males. A significant negative correlation was observed between VA and RT (p = 0.003; r = -0.622), indicating that lower VA was associated with longer RTs. A similar pattern emerged for RT and performance in the 30sCST (p = 0.011; r = -0.541), with shorter RTs associated with a higher number of repetitions.
CONCLUSION:
Although limited by the small sample size, these preliminary findings indicate that VR‑based measures of VA and, in particular, RT may capture neurocognitive processes that are closely related to fall‑related performance, underscoring the potential contribution of non‑traditional factors to fall risk in older adults.