Dataset Information

One-Legged Balance Performance and Fall Risk in Mid and Later Life: Longitudinal Evidence From a British Birth Cohort.

ABSTRACT:

Introduction

The one-legged balance test is widely used as a fall risk screening tool in both clinical and research settings. Despite rising fall prevalence in midlife, there is little evidence examining balance and fall risk in those aged <65 years. This study investigated the longitudinal associations between one-legged balance and the number of falls between ages 53 and 68 years.

Methods

The study included 2,046 individuals from the Medical Research Council National Survey of Health & Development, a British birth cohort study. One-legged balance times (eyes open, maximum: 30 seconds) were assessed at ages 53 years (1999) and 60-64 years (2006-2010). Fall history within the last year (none, 1, ≥2) was self-reported at ages 60-64 years and 68 years (2014). Multinomial logistic regressions assessed the associations between balance and change in balance with subsequent falls. Models adjusted for anthropometric, socioeconomic, behavioral, health status, and cognitive indicators. Analysis occurred between 2019 and 2022.

Results

Balance performance was not associated with single falls. Better balance performance at age 53 years was associated with decreased risk of recurrent falls at ages 60-64 years and 68 years, with similar associations between balance at age 60-64 years and recurrent falls at age 68 years. Those with consistently lower balance times (<15 seconds) were at greater risk (RRR=3.33, 95% CI=1.91, 5.80) of recurrent falls at age 68 years in adjusted models than those who could balance for 30 seconds at ages 53 years and 60-64 years.

Conclusions

Lower balance and consistently low or declining performance were associated with a greater subsequent risk of recurrent falls. Earlier identification and intervention of those with poor balance ability can help to minimize the risk of recurrent falls in aging adults.

SUBMITTER: Blodgett JM

PROVIDER: S-EPMC10499759 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

One-Legged Balance Performance and Fall Risk in Mid and Later Life: Longitudinal Evidence From a British Birth Cohort.

Blodgett Joanna M JM Hardy Rebecca R Davis Daniel D Peeters Geeske G Kuh Diana D Cooper Rachel R

American journal of preventive medicine 20220820 6

<h4>Introduction</h4>The one-legged balance test is widely used as a fall risk screening tool in both clinical and research settings. Despite rising fall prevalence in midlife, there is little evidence examining balance and fall risk in those aged <65 years. This study investigated the longitudinal associations between one-legged balance and the number of falls between ages 53 and 68 years.<h4>Methods</h4>The study included 2,046 individuals from the Medical Research Council National Survey of H ...[more]

PMID: 35995713

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Project description:IntroductionDespite its associations with falls, disability, and mortality, balance is an under-recognized and frequently overlooked aspect of aging. Studies investigating associations between factors across life and balance are limited. Understanding the factors related to balance performance could help identify protective factors and appropriate interventions across the life course. This study aimed to: (i) identify socioeconomic, anthropometric, behavioral, health, and cognitive factors that are associated with one-legged balance performance; and (ii) explore how these associations change with age.MethodsData came from 3,111 members of the MRC National Survey of Health and Development, a British birth cohort study. Multilevel models examined how one-legged standing balance times (assessed at ages 53, 60-64, and 69) were associated with 15 factors across life: sex, maternal education (4 years), paternal occupation (4 years), own education (26 years), own occupation (53 years), and contemporaneous measures (53, 60-64, 69 years) of height, BMI, physical activity, smoking, diabetes, respiratory symptoms, cardiovascular events, knee pain, depression and verbal memory. Age and sex interactions with each variable were assessed.ResultsMen had 18.8% (95%CI: 13.6, 23.9) longer balance times than women at age 53, although this difference decreased with age (11.8% at age 60-64 and 7.6% at age 69). Disadvantaged socioeconomic position in childhood and adulthood, low educational attainment, less healthy behaviors, poor health status, lower cognition, higher body mass index (BMI), and shorter height were associated with poorer balance at all three ages. For example, at age 53, those from the lowest paternal occupational classes had 29.6% (22.2, 38.8) worse balance than those from the highest classes. Associations of balance with socioeconomic indicators, cognition and physical activity became smaller with age, while associations with knee pain and depression became larger. There were no sex differences in these associations. In a combined model, the majority of factors remained associated with balance.DiscussionThis study identified numerous risk factors across life that are associated with one-legged balance performance and highlighted diverse patterns of association with age, suggesting that there are opportunities to intervene in early, mid and later life. A multifactorial approach to intervention, at both societal and individual levels, may have more benefit than focusing on a single risk factor.

Project description:IntroductionThe one-legged balance test is a common screening tool for fall risk. Yet, there is little empirical evidence assessing its prognostic ability. The study aims were to assess the prognostic accuracy of one-legged balance performance in predicting falls and identify optimal cut-points to classify those at greater risk.MethodsData from up to 2,000 participants from a British birth cohort born in 1,946 were used. The times an individual could stand on one leg with their eyes open and closed were recorded (max: 30 s) at ages 53 and 60-64. Number of falls in the past year was self-reported at ages 53, 60-64 and 68; recurrent falls (0-1 vs. 2+) and any fall (0 vs. 1+) were considered binary outcomes. Four longitudinal associations between balance times and subsequent falls were investigated (age 53 → 60-64; age 53 → 68; age 60-64 → 68; age 53 & 60-64 → 68). For each temporal association, areas under the curve (AUC) were calculated and compared for a base sex-only model, a sex and balance model, a sex and fall history model and a combined model of sex, balance and fall history. The Liu method was used to identify optimal cut-points and sensitivity, specificity, and AUC at corresponding cut-points.ResultsMedian eyes open balance time was 30 s at ages 53 and 60-64; median eyes closed balance times were 5 s and 3 s, respectively. The predictive ability of balance tests in predicting either fall outcome was poor (AUC range for sex and balance models: 0.577-0.600). Prognostic accuracy consistently improved by adding fall history to the model (range: 0.604-0.634). Optimal cut-points ranged from 27 s to 29 s for eyes open and 3 s to 5 s for eyes closed; AUC consistently indicated that using "optimal" cut-points to dichotomise balance time provided no discriminatory ability (AUC range:0.42-0.47), poor sensitivity (0.38-0.61) and poor specificity (0.23-0.56).DiscussionDespite previous observational evidence showing associations between better one-legged balance performance and reduced fall risk, the one-legged balance test had limited prognostic accuracy in predicting recurrent falls. This contradicts ongoing translation of this test into clinical screening tools for falls and highlights the need to consider new and existing screening tools that can reliably predict fall risk.

Project description:Evidence for the contribution of individual foods and nutrients to bone health is weak. Few studies have considered hypothesis-based dietary patterns and bone health. We investigated whether a protein-calcium-potassium-rich (PrCaK-rich) dietary pattern over the adult life course, was positively associated with bone outcomes at 60 to 64 years of age. Diet diaries were collected at ages 36, 46, 53, and 60 to 64 years in 1263 participants (661 women) from the MRC National Survey of Health and Development. DXA and pQCT measurements were obtained at age 60 to 64 years, including size-adjusted bone mineral content (SA-BMC) and volumetric bone mineral density (vBMD). A food-based dietary pattern best explaining dietary calcium, potassium, and protein intakes (g/1000 kcal) was identified using reduced rank regression. Dietary pattern Z-scores were calculated for each individual, at each time point. Individual trajectories in dietary pattern Z-scores were modeled to summarize changes in Z-scores over the study period. Regression models examined associations between these trajectories and bone outcomes at age 60 to 64 years, adjusting for baseline dietary pattern Z-score and other confounders. A consistent PrCaK-rich dietary pattern was identified within the population, over time. Mean ± SD dietary pattern Z-scores at age 36 years and age 60 to 64 years were -0.32 ± 0.97 and 2.2 ± 1.5 (women) and -0.35 ± 0.98 and 1.7 ± 1.6 (men), respectively. Mean trajectory in dietary pattern Z-scores ± SD was 0.07 ± 0.02 units/year. Among women, a 0.02-SD unit/year higher trajectory in dietary pattern Z-score over time was associated with higher SA-BMC (spine 1.40% [95% CI, 0.30 to 2.51]; hip 1.35% [95% CI, 0.48 to 2.23]), and vBMD (radius 1.81% [95% CI, 0.13 to 3.50]) at age 60 to 64 years. No statistically significant associations were found in men. During adulthood, an increasing score for a dietary pattern rich in protein, calcium, and potassium was associated with greater SA-BMC at fracture-prone sites in women. This study emphasizes the importance of these nutrients, within the context of the whole diet, to bone health. © 2016 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research (ASBMR).

Project description:BackgroundWe sought to: [1] estimate the prevalence of multimorbidity at age 46-48 in the 1970 British Cohort Study-a nationally representative sample in mid-life; and [2] examine the association between early-life characteristics and mid-life multimorbidity.MethodA prospective longitudinal birth cohort of a community-based sample from the 1970 British Cohort Study (BCS70). Participants included all surviving children born in mainland Britain in a single week in April 1970; the analytical sample included those with valid data at age 46-48 (n = 7951; 2016-2018). The main outcome was multimorbidity, which was operationalised as a binary indicator of two or more long-term health conditions where at least one of these conditions was of physical health. It also included symptom complexes (e.g., chronic pain), sensory impairments, and alcohol problems.ResultsPrevalence of mid-life multimorbidity was 33.8% at age 46-48. Those with fathers from unskilled social occupational class (vs professional) at birth had 43% higher risk of mid-life multimorbidity (risk ratio = 1.43, 95% confidence interval 1.15 to 1.77). After accounting for potential child and family confounding, an additional kilogram of birthweight was associated with 10% reduced risk of multimorbidity (risk ratio = 0.90, 95% confidence interval 0.84 to 0.96); a decrease of one body mass index point at age 10 was associated with 3% lower risk (risk ratio = 1.03, 95% confidence interval 1.01 to 1.05); one standard deviation higher cognitive ability score at age 10 corresponded to 4% lower risk (risk ratio = 0.96, 95% confidence interval 0.91 to 1.00); an increase of one internalising problem at age 16 was equated with 4% higher risk (risk ratio = 1.04, 95% confidence interval 1.00 to 1.08) and of one externalising problem at age 16 with 6% higher risk (risk ratio = 1.06, 1.03 to 1.09).ConclusionPrevalence of multimorbidity was high in mid-life (33.8% at age 46-48) in Britain. Potentially modifiable early-life exposures, including early-life social circumstances, cognitive, physical and emotional development, were associated with elevated risk of mid-life multimorbidity.

Dataset Information

One-Legged Balance Performance and Fall Risk in Mid and Later Life: Longitudinal Evidence From a British Birth Cohort.

Introduction

Methods

Results

Conclusions

Publications

One-Legged Balance Performance and Fall Risk in Mid and Later Life: Longitudinal Evidence From a British Birth Cohort.

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