Change in balance ability in midlife and subsequent risk of falling: findings from a British cohort study

Introduction: Falls are a leading cause of injury, functional impairment, and death in older adults, with nearly 50% of individuals over the age of 65 reporting a fall in the last year. Full recovery from falls after hospitalisation is difficult and a fall can often represent a negative turning point in the health of an older adult. A proactive approach to identifying risk factors for falls has focused on balance impairment. There is strong evidence that poor balance ability is an important predictor of falls, however this research has only targeted those 65+. Objective and methods: To assess whether there may be utility in extending screening to younger ages, we investigated if change in balance performance in midlife was associated with subsequent falls risk. We used data from the 1946 British birth cohort, a study of 5000+ individuals who have been followed since birth until present day. Balance was measured at age 53 and age 63, and falls were self-reported at age 63 and 68. Results and conclusions: Fall risk was greatest in those with consistently low balance at ages 53 and 63, followed by those who demonstrated a decline between ages 53 and 63. These associations were greatest for those experiencing multiple falls. Implementation of balance screening at earlier ages may help identify those at risk of falling in order to intervene earlier. Evidence has shown that balance training interventions can significantly decrease the risk of falling; this warrants further research.