Balance Impairments and Fracture Risk in 70-Year-Old Adults
Overview
This cohort study of 5437 community-dwelling 70-year-olds found that increased body sway velocity and variability, especially under eyes-closed and dual-task conditions, were associated with higher fracture risk. Associations were observed in both men and women over a mean follow-up of 4.8 years.
Background
Falls are a leading cause of injury-related death among older adults, often resulting in fractures that impose significant health and economic burdens. Balance impairment is a modifiable risk factor for falls, influenced by sensory and cognitive challenges. However, the specific relationships between balance under different conditions and fracture risk remain unclear. Understanding these associations can inform targeted fall-prevention strategies in aging populations.
Data Highlights
Parameter
Condition
Hazard Ratio (HR) per Unit Increase
95% Confidence Interval
Sex
Anterior-posterior sway velocity
Dual-tasking
1.05 per mm/s
1.01-1.08
Women
Variation in sway velocity
Dual-tasking
1.05 per SD
1.01-1.09
Women
Lateral sway measures
Eyes closed
Significant (P < .01)
Not specified
Women
Variation in lateral sway velocity
Dual-tasking
1.03 per SD
1.00-1.07
Men
Variation in anterior-posterior sway velocity
Dual-tasking
1.05 per SD
1.01-1.10
Men
Key Findings
Higher anterior-posterior sway velocity and variability during dual-tasking are linked to increased fracture risk in women.
All lateral sway measures with eyes closed are significantly associated with fracture risk in women.
In men, increased variation in lateral and anterior-posterior sway velocity during dual-tasking correlates with higher fracture risk.
Balance impairments under challenging conditions (eyes closed, multitasking) better predict fracture risk than eyes-open conditions.
Body sway velocity and its variability are important markers for fracture risk assessment in older adults.
Clinical Implications
Assessment of balance under multitasking and eyes-closed conditions may improve identification of older adults at higher fracture risk. Incorporating such balance tests into routine evaluations could guide targeted interventions. Fall-prevention programs should emphasize training under sensory and cognitive challenges to reduce fracture incidence.
Conclusion
Increased body sway velocity and variability, particularly under challenging balance conditions, are associated with higher fracture risk in 70-year-old adults. These findings support the use of dynamic balance assessments to enhance fracture risk stratification and prevention efforts.
References
Healthy Ageing Initiative/Umeå Municipality/2023 -- Links Between Balance Assessments and Fracture Risk in Individuals Aged 70 Years
