Discordance Between Actual and Perceived Balance Ability Relates to Quality of Life and Global Cognition in a Clinical Sample of Parkinson Patients

Authors

• Daniel S. Peterson, Arizona State University
• Jason K. Longhurst, Saint Louis University
• Franziska Albrecht, Karolinska Institutet
• Joanna Weller, NYU Grossman Long Island
• Jennifer Vasquez, NYU Grossman Long Island
• Myassar Zarif, NYU Grossman Long Island
• Mark Gudesblatt, NYU Grossman Long Island
• Andrew Hooyman, Chapman UniversityFollow

Document Type

Article

Publication Date

3-23-2026

Abstract

Background

Misalignment between actual and perceived balance ability provides relevant information to understand functional deficits and fall risk. However, few studies have provided a continuous quantification of misalignment in neurological populations such as people with Parkinson's disease (PD).

Objective

Determine whether a continuous quantification of misalignment between actual and perceived balance ability, discordance, relates to functional outcomes such as quality of life and cognition.

Methods

Actual (gait velocity), and perceived (Activities of Balance Confidence) balance, cognition (measured via a computer-based cognitive assessment), and mobility-related quality of life were captured in a clinical sample of 95 people with PD. Primary outcomes were quality of life and cognitive domains frequently altered in people with PD (global cognition & executive function). Secondary cognitive domains assessed were attention, memory, visuo-spatial, verbal function, and information processing. Linear and non-linear models assessed the relationship between discordance, quality of life, and cognition.

Results

Discordance related to mobility-related quality of life, such that under-confidence was related to poorer quality of life. Non-linear (quadratic) models were shown to fit the discordance-Global cognition (p = 0.02) data better than linear models such that over- and under-confidence related to poorer cognition. Secondary cognitive domains were not robustly related to discordance.

Conclusions

In a clinical sample of people with PD, discordance was related to mobility-related quality of life and global cognition. Global cognition further exhibited a possible non-linear relationship to discordance indicating that over- or under-confidence may relate to poorer cognition. This work underscores the functional relevance of misalignment of actual and balance abilities.

Comments

This article was originally published in Journal of Parkinson’s Disease in 2026. https://doi.org/10.1177/1877718X261423310

Recommended Citation

Peterson DS, Longhurst JK, Albrecht F, et al. Discordance between actual and perceived balance ability relates to quality of life and global cognition in a clinical sample of Parkinson patients. Journal of Parkinson’s Disease. 2026;0(0). https://doi.org/10.1177/1877718X261423310

Peer Reviewed

1

Copyright

The authors

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 License.