The Relationship of Balance Disorders with Falling, the Effect of Health Problems, and Social Life on Postural Balance in the Elderly Living in a District in Turkey

Tahsin Barış Değer, Zeliha Fulden Saraç, Emine Sumru Savaş, Selahattin Fehmi Akçiçek, Tahsin Barış Değer, Zeliha Fulden Saraç, Emine Sumru Savaş, Selahattin Fehmi Akçiçek

Abstract

The aim of this study was to determine the prevalence of balance disorders; the effects of sociodemographic, medical, and social conditions on postural balance; and the relationship between balance and falls in elderly individuals. The study design was cross-sectional. A total of 607 community-dwelling elderly individuals with a mean age of 73.99 ± 6.6 years were enrolled after being selected by stratified random sampling. The study was performed as a face-to-face survey in the homes of elderly individuals. Sociodemographic and medical data were obtained from elderly individuals using the Elderly Identification Form. Balance disorders were determined using the Berg Balance Scale (BBS). In this study, the prevalence of balance disorders was found to be 34.3% in the community-dwelling elderly. Older age, physical disability, having four or more chronic illnesses, the presence of incontinence, having a history of falls, not walking regularly, absence of free time activity, and obesity were found to be associated with an increased prevalence of balance disorders. Balance disorders are commonly seen in the elderly and may be triggered by a variety of biological and social factors. It is crucial to develop and implement national health and social policies to eliminate the causes of this problem, as well as to prioritize preventive health services in the ever-increasing elderly population.

Keywords: balance disorder; elderly; fall; medical conditions; prevalence; social mobility.

Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

References

    1. Sturnieks D.L., St George R., Lord S.R. Balance disorders in the elderly. Neurophysiol. Clin. 2008;38:467–478. doi: 10.1016/j.neucli.2008.09.001.
    1. Nnodim J.O., Yung R.L. Balance and its clinical assessment in older adults—A review. J. Geriatr. Med. Gerontol. 2015;1:003. doi: 10.23937/2469-5858/1510003.
    1. Perera T., Tan J.L., Cole M.H., Yohanandan S.A.C., Silberstein P., Cook R., Peppard R., Aziz T., Coyne T., Brown P., et al. Balance control systems in Parkinson’s disease and the impact of pedunculopontine area stimulation. Brain. 2018;141:3009–3022. doi: 10.1093/brain/awy216.
    1. Cameron I.D., Dyer S.M., Panagoda C.E., Murray G.R., Hill K.D., Cumming R.G., Kerse N. Interventions for preventing falls in older people in care facilities and hospitals. Cochrane Database Syst. Rev. 2018:9. doi: 10.1002/14651858.CD005465.pub4.
    1. Bergen G., Stevens M.R., Burns E.R. Falls and fall injuries among adults aged ≥65 years—United States, 2014. MMWR Morb. Mortal. Wkly. Rep. 2016;65:993–998. doi: 10.15585/mmwr.mm6537a2.
    1. Covington D.L., Maxwell J.G., Clancy T.V. Hospital resources used to treat the injured elderly at North Carolina trauma centers. J. Am. Geriatr. Soc. 1993;41:847–852. doi: 10.1111/j.1532-5415.1993.tb06182.x.
    1. Onat Ş.Ş., Delialioğlu S.Ü., Özel S. The relationship of balance between functional status and quality of life in the geriatric population. Turk. J. Phys. Med. Rehabil. 2014;60:147–154. doi: 10.5152/tftrd.2014.67366.
    1. Nguyen T.Q., Young J.H., Rodriguez A., Zupancic S., Lie D.Y.C. Differentiation of patients with balance insufficiency (vestibular hypofunction) versus normal subjects using a low-cost small wireless wearable gait sensor. Biosensors. 2019;9:29. doi: 10.3390/bios9010029.
    1. Von Brevern M., Radtke A., Lezius F., Feldmann M., Ziese T., Lempert T., Neuhauser H. Epidemiology of benign paroxysmal positional vertigo: A population based study. J. Neurol Neurosurg. Psychiatr. 2007;78:710–715. doi: 10.1136/jnnp.2006.100420.
    1. Felsenthal G., Ference T.S., Young M.A. Aging of organ systems. In: Gonzales E.G., Myers S.A., Edelstein J.E., Lieberman J.S., Downey J.A., editors. Downey and Darling’s Physiological Basis of Rehabilitation Medicine. 3th ed. Butterwoth Heinemann; Boston, MA, USA: 2001. pp. 561–577.
    1. Salzman B. Gait and balance disorders in older adults. Am. Fam. Physician. 2010;82:61–68.
    1. World Health Organization WHO global report on falls prevention in older age. [(accessed on 23 February 2019)];2007 :15–18. Available online: .
    1. Turkey Healthy Aging Action Plan and Implementation Programme 2015–2020, Ankara. [(accessed on 24 February 2019)];2015 :33. Available online: . (In Turkish)
    1. Güngen C., Ertan T., Eker E., Yaşar R., Engin F. Reliability and Validity of The Standardized Mini Mental State Examination in The Diagnosis of Mild Dementia in Turkish Population. Turk. J. Psychiatry. 2002;13:273–281.
    1. Berg K.O., Maki B.E., Williams J.I., Holliday P.J., Wood-Dauphinee S.L. Clinical and laboratory measures of postural balance in an elderly population. Arch. Phys. Med. Rehabil. 1992;73:1073–1080.
    1. Berg K., Wood-Dauphinee S., Williams J.I., Maki B. Measuring balance in the elderly: Validation of an instrument. Can. J. Pub. Health. 1992;2:7–11.
    1. Berg K., Wood-Dauphinee S., Williams J.I. The Balance Scale: Reliability assessment with elderly residents and patients with an acute stroke. Scand. J. Rehabil. Med. 1995;27:27–36.
    1. Sahin F., Yilmaz F., Ozmaden A., Kotevolu N., Sahin T., Kuran B. Reliability and validity of the Turkish version of the Berg Balance Scale. J. Geriatr. Phys. Ther. 2008;31:32–37. doi: 10.1519/00139143-200831010-00006.
    1. Kornetti D.L., Fritz S.L., Chiu Y.P., Light K.E., Velozo C.A. Rating scale analysis of the Berg Balance Scale. Arch. Phys. Med. Rehabil. 2004;85:1128–1135. doi: 10.1016/j.apmr.2003.11.019.
    1. Dogan A., Mengulluoglu M., Ozgırgın N. Evaluation of the effect of ankle-foot orthosis use on balance and mobility in hemiparetic stroke patients. Disabil. Rehabil. 2011;33:1433–1439. doi: 10.3109/09638288.2010.533243.
    1. Stevens K.N., Lang I.A., Guralnik J.M., Melzer D. Epidemiology of balance and dizziness in a national population: Findings from the English Longitudinal Study of Ageing. Age Ageing. 2008;37:300–305. doi: 10.1093/ageing/afn019.
    1. Lin H.W., Bhattacharyya N. Balance Disorders in the elderly: Epidemiology and functional impact. Laryngoscope. 2012;122:1858–1861. doi: 10.1002/lary.23376.
    1. Colledge N.R., Wilson J.A., Macintyre C.C., Mac Lennan W.J. The prevalence and characteristics of dizziness in an elderly community. Age Ageing. 1994;23:117–120. doi: 10.1093/ageing/23.2.117.
    1. Hawk C., Hyland J.K., Rupert R., Colonvega M., Hall S. Assessment of balance and risk for falls in a sample of community-dwelling adults aged 65 and older. Chiropr. Osteopat. 2006;14:3. doi: 10.1186/1746-1340-14-3.
    1. Soyuer F., Şenol V., Elmalı F. Physical activity, balance and mobility functions of individuals over 65 years of age in the nursing homes. [(accessed on 5 February 2019)];Van Med. J. 2012 19:116–121. (In Turkish) Available online:
    1. Holbein-Jenny M.A., Billek-Sawhney B., Beckman E., Smith T. Balance in personal care home residents: A comparison of the Berg Balance Scale, the Multi-Directional Reach Test, and the Activities-Specific Balance Confidence Scale. J. Geriatr. Phys. Ther. 2005;28:48–53. doi: 10.1519/00139143-200508000-00003.
    1. Ulus Y., Akyol Y., Tander B., Durmuş D., Bilgici A., Kuru Ö. The relationship between fear of falling and balance in community-dwelling older people. [(accessed on 11 February 2019)];Turk. J. Geriatr. 2013 16:260–265. Available online:
    1. Steffen T.M., Hacker T.A., Mollinger L. Age and gender related test performance in community-dwelling elderly people: Six-minute walk test, Berg Balance Scale, timed up-go test and gait speeds. Physical. Ther. 2002;82:128–137. doi: 10.1093/ptj/82.2.128.
    1. Guimarâes J.M.N., Farinatti P.T.V. Descriptive analysis of variables theoretically associated to the risk of falls in elder women. [(accessed on 11 February 2019)];Rev. Bras. Med. Esport. 2005 11:280–286. Available online:
    1. Popescu M.L., Boisjoly H., Schmaltz H., Kergoat M.J., Rousseau J., Moghadaszadeh S., Djafari F., Freeman E.E. Age-related eye disease and mobility limitations in older adults. Invest. Ophthalmol. Vis. Sci. 2011;9:7168–7174. doi: 10.1167/iovs.11-7564.
    1. Kotecha A., Chopra R., Fahy R.T., Rubin G.S. Dual tasking and balance in those with central and peripheral vision loss. Invest. Ophthalmol Vis. Sci. 2013;54:5408–5415. doi: 10.1167/iovs.12-12026.
    1. Sherrington C., Fairhall N.J., Wallbank G.K., Tiedemann A., Michaleff Z.A., Howard K., Clemson L., Hopewell S., Lamb S.E. Exercise for preventing falls in older people living in the community. Cochrane Database Syst. Rev. 2019;31 doi: 10.1002/14651858.CD012424.pub2.
    1. Soto-Varela A., Gayoso-Diz P., Faraldo-García A., Rossi-Izquierdo M., Vaamonde-Sánchez-Andrade I., Del-Río-Valeiras M., Lirola-Delgado A., Santos-Pérez S. Optimising costs in reducing rate of falls in older people with the improvement of balance by means of vestibular rehabilitation (ReFOVeRe study): A randomized controlled trial comparing computerised dynamic posturography vs. mobile vibrotactile posturography system. BMC Geriatr. 2019;19:1. doi: 10.1186/s12877-018-1019-5.
    1. Ek S., Rizzuto D., Fratiglioni L., Calderón-Larrañaga A., Johnell K., Sjöberg L., Xu W., Welmer A.K. Risk factors for injurious falls in older adults: The role of sex and length of follow-up. J. Am. Geriatr Soc. 2019;67:246–253. doi: 10.1111/jgs.15657.
    1. Jeon M., Gu M.O., Yim J. Comparison of Walking, Muscle Strength, Balance, and Fear of Falling Between Repeated Fall Group, One-time Fall Group, and Nonfall Group of the ElderlyReceiving Home Care Service. Asian Nurs. Res. (Korean Soc. Nurs. Sci). 2017;11:290–296. doi: 10.1016/j.anr.2017.11.003.
    1. Vellas B.J., Wayne S.J., Romero L.J., Baumgartner R.N., Garry P.J. Fear of falling and restriction of mobility in elderly fallers. Age Ageing. 1997;26:189–193. doi: 10.1093/ageing/26.3.189.
    1. Gao X., Wang L., Shen F., Ma Y., Fan Y., Niu H. Dynamic walking stability of elderly people with various BMIs. Gait Posture. 2019;68:168–173. doi: 10.1016/j.gaitpost.2018.11.027.
    1. Nonaka K., Murata S., Shiraiwa K., Abiko T., Nakano H., Iwase H., Naito K., Horie J. Physical characteristics vary according to body mass index in Japanese community-dwelling elderly women. Geriatrics. 2018;3:87. doi: 10.3390/geriatrics3040087.
    1. Tkacheva O.N., Runikhina N.K., Ostapenko V.S., Sharashkina N.V., Mkhitaryan E.A., Onuchina J.S., Lysenkov S.N., Yakhno N.N., Press Y. Prevalence of geriatric syndromes among people aged 65 years and older at four community clinics in Moscow. Clin. Interv. Aging. 2018;13:251–259. doi: 10.2147/CIA.S153389.
    1. Almeida Abreu H.C., Oliveira Reiners A.A., Souza Azevedo R.C., Silva A.M.C., Oliveira Moura Abreu D.R., Oliveira A.D. Incidence and predicting factors of falls of older inpatients. Rev. Saude Publica. 2015;49 doi: 10.1590/S0034-8910.2015049005549.

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