Abstract
To better understand the various individual factors that contribute to balance and the relation to fall risk, we performed the modified Romberg Test of Standing Balance on Firm and Compliant Support, with 1,174 participants between 4 and 83 years of age. This research was conducted in the Living Laboratory® at the Museum of Science, Boston. We specifically focus on balance test condition 4, in which individuals stand on memory foam with eyes closed, and must rely on their vestibular system; therefore, performance in this balance test condition provides a proxy for vestibular function. We looked for balance variations associated with sex, race/ethnicity, health factors, and age. We found that balance test performance was stable between 10 and 39 years of age, with a slight increase in the failure rate for participants 4–9 years of age, suggesting a period of balance development in younger children. For participants 40 years and older, the balance test failure rate increased progressively with age. Diabetes and obesity are the two main health factors we found associated with poor balance, with test condition 4 failure rates of 57 and 19%, respectively. An increase in the odds of having fallen in the last year was associated with a decrease in the time to failure; once individuals dropped below a time to failure of 10 s, there was a significant 5.5-fold increase in the odds of having fallen in the last 12 months. These data alert us to screen for poor vestibular function in individuals 40 years and older or suffering from diabetes, in order to undertake the necessary diagnostic and rehabilitation measures, with a focus on reducing the morbidity and mortality of falls.
Highlights
Falls are a leading cause of injury and death throughout the world
Among all adults, the condition 4 (C4) failure rate was 12.65% [95% confidence interval (CI): 10.36–15.24%], while it was 21.70% for participants aged 40 years and older
1.7% of adults who passed C4 by maintaining balance for 30 s reported falls in the previous year, whereas for those who were only able to maintain balance for less than 10 s, fall prevalence was 8.5%—five times higher than for participants who passed C4 (Table 5). Consistent with this prevalence finding, the odds of falling increased as the time to failure shortened, reaching statistical significance only for participants who failed in less than 10 s, having a 5.6-fold increase in the odds of falling (Table 5). These findings suggest that vestibular contributions to balance are relatively stable between the ages of 10–39, with the lowest C4 failure rate for participants 30–39 years of age (3.52%)
Summary
Falls are a leading cause of injury and death throughout the world. In 2003 in the US, fatal falls or hospitalizations for hip fractures occurred at a rate of approximately 36.8 per 100,000 people aged 65 and older [1]. According to the World Health Organization (WHO) [2], “falls and consequent injuries are major public health problems. Falls lead to 20–30% of mild to severe injuries, and are the underlying cause of 10–15% of all emergency department visits. Falls [] account for 40% of all injury deaths.”
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