Comparing balance using the BESTest in Alzheimer, Huntington and Parkinson disease

<b>Aim:</b> Individuals with Alzheimer disease (AD), Huntington disease (HD) and Parkinson disease (PD) have impaired balance, and comparing these deficits could improve management of neurological diseases. <b>Methods:</b> Scores on the Balance Evaluation Systems Test (BESTest) were compared across three groups, consisting of individuals with AD, HD and PD in early stages of their respective disease. <b>Results:</b> Individuals with PD had significantly higher scores on the BESTest than individuals with AD (95% CI [4.30, 21.37], <i>p</i> &lt; 0.01) or HD (95% CI [6.53, 24.18], <i>p</i> &lt; 0.001). Individuals with AD and HD were not significantly different on the overall BESTest or any of its subsections. <b>Conclusion:</b> AD and HD may have overlapping pathologies resulting in early and similar balance impairments in these groups. Balance impairment differs among individuals with Alzheimer disease, Huntington disease and Parkinson disease, with individuals with Parkinson disease demonstrating significantly better balance when compared in early stages of each disease. Neurodegenerative diseases including Alzheimer, Huntington, and Parkinson disease have overlapping signs and symptoms. Understanding how overlapping symptoms, like balance impairment, differ in each of these conditions could help guide treatment. The Balance Evaluation Systems Test (BESTest) breaks balance down into six subsections, allowing for better identification of specific balance impairments. Individuals with Parkinson disease have significantly better balance, as measured by the BESTest, than individuals with Alzheimer disease and Huntington disease at a similar early disease stage. Individuals with Alzheimer disease and Huntington disease had lowest scores on dynamic balance subsections of the BESTest (III, IV and VI). Individuals with Alzheimer disease and Huntington disease were not significantly different on any of the subsections of the BESTest. Cognitive impairment may contribute to the balance impairments in individuals with Alzheimer disease and Huntington disease. Future research should focus on how balance changes over time in these diseases, and how cognitive impairment may relate to these changes.