Increased postural sway during quiet stance as a risk factor for prospective falls in community-dwelling elderly individuals

Johansson, Jonas; Nordström, Anna; Gustafson, Yngve; Westling, G.; Nordström, Peter

doi:10.1093/ageing/afx083

Cited by 137 publications

(149 citation statements)

References 29 publications

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“…These findings were used to provide valuable percentile ranking information that can assist in assessing the postural sway abnormalities known to be a risk factor for falling in older adults. [5][6][7][8][9]21,22 The age effects on postural sway shown in the present study are consistent with a multitude of previous works on age-related changes in postural sway. [11][12][13][14][15] From a mechanistic standpoint, age-related postural sway reductions are most often ascribed to deficits in sensory feedback from the visual, proprioceptive and vestibular systems.…”

Section: Discussionsupporting

confidence: 92%

“…BMI) and BBT performance. These findings were used to provide valuable percentile ranking information that can assist in assessing the postural sway abnormalities known to be a risk factor for falling in older adults …”

Section: Discussionmentioning

confidence: 99%

“…In conclusion, BTrackS is an emerging clinical tool that, combined with the percentile ranking normative data in the present study, translates into the field as an objective means of determining abnormalities in postural sway. Such abnormalities have previously been associated with a number of poor clinical outcomes including, importantly, increased fall risk . Fortunately, once identified, postural sway deficits can be treated by using exercise‐based training interventions .…”

Section: Discussionmentioning

confidence: 99%

“…Older adults without a history of falling have a greater magnitude COP on average than those who fall repeatedly . Furthermore, retrospective and prospective analyses have shown a greater likelihood of falling for those with increased postural sway, compared with those with postural sway more typical of young adults …”

Section: Introductionmentioning

confidence: 99%

“…[5][6][7] Furthermore, retrospective and prospective analyses have shown a greater likelihood of falling for those with increased postural sway, compared with those with postural sway more typical of young adults. [5][6][7][8][9] Given the clear value of carrying out older adult postural sway assessments with a force plate, it is somewhat surprising that this methodology is not more widely utilized. The most likely barriers to force plate implementation are the high cost (~$5000-$20 000) and lack of portability (i.e.…”

Section: Introductionmentioning

confidence: 99%

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Postural sway normative data across the adult lifespan: Results from 6280 individuals on the Balance Tracking System balance test

Goble

Baweja

2018

Geriatrics Gerontology Int

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Postural sway normative data across the adult lifespan: Results from 6280 individuals on the Balance Tracking System balance test

Goble

Baweja

2018

Geriatrics Gerontology Int

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Ankle flexor/extensor strength and muscle density are complementary determinants of balance during dual‐task engagement: The ankle quality study

Wong

Fung

Pretty

et al. 2023

JCSM Clinical Reports

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Background This study investigated relative contributions of ankle flexor torque, muscle size, and density on balance and falls. Methods Men and women ≥50 years of age completed a peripheral quantitative computed tomography scan of the mid‐leg to quantify muscle density (MD) and cross‐sectional area; Biodex dynamometry to evaluate maximal isometric ankle flexor torque; and a single‐leg balance test on a force platform with/without eyes closed and cognitive task. Ankle flexor torque, muscle size, and density individually, together, or as interactions were examined for associations with balance (mean step duration, steps/trial) in general linear models, or with falls in Poisson regression, adjusting for age, sex, BMI, glucocorticoid use, osteoarthritis, and physical activity. Visuo‐cognitive conditions were compared. Results Among 105 participants (age: 63.3 ± 9.9 years, BMI: 25.8 ± 5.4 kg/m2, 77.1% female), 41.8% experienced ≥1 fall in the last year. Balance on one leg was dependent on ankle flexor torque when eyes were open (r = −0.220 to −0.284) and on having leaner mid‐leg muscles when eyes were closed (r = −0.123 to −0.142); cognitive challenge blunted these correlations. Individuals with leaner muscles tended to rely more on plantarflexors than dorsiflexors. A 2% lower step‐free fraction in the eyes‐closed paradigm associated with having 1 additional fall [−0.701(−1.235, −0.167)], but neither torque, muscle density, nor size related to number of falls. Conclusions Among ambulatory adults, ankle flexor torque and muscle density showed an interactive influence on balance that depended on visuo‐cognitive input. The complementary roles of torque and muscle density on balance suggest redundancy is important under dual‐tasking conditions.

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Adiposity Without Obesity: Associations with Osteoporosis, Sarcopenia, and Falls in the Healthy Ageing Initiative Cohort Study

Scott

Johansson

Ebeling

et al. 2020

Obesity

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Objective Obesity is commonly defined by BMI rather than adiposity, which may have differential effects on musculoskeletal health. Musculoskeletal outcomes were compared in older adults with normal adiposity and normal BMI (NA‐NBMI), those with high adiposity but normal BMI (HA‐NBMI), and those with high adiposity and high BMI (HA‐HBMI). Methods In 3,411 70‐year‐olds, obesity was defined as BMI ≥ 30 kg/m2 and adiposity as body fat percentage ≥ 25% (men) or ≥ 35% (women) from dual‐energy x‐ray absorptiometry. Bone parameters were measured by dual‐energy x‐ray absorptiometry and peripheral quantitative computed tomography. Sarcopenia was defined as low handgrip strength with or without low appendicular lean mass. Falls were self‐reported 6 and 12 months later. Results Prevalence of NA‐NBMI, HA‐NBMI, and HA‐HBMI was 14.2%, 68.1%, and 17.7%, respectively. Compared with HA‐HBMI, HA‐NBMI had increased likelihood for sarcopenia (adjusted odds ratio: 3.99; 95% CI: 1.41‐11.32) and osteoporosis (2.91; 95% CI: 2.35‐3.61) but similar likelihood of falls (P > 0.05). HA‐NBMI had lower values for bone geometry parameters, as well as grip strength, than both NA‐NBMI and HA‐HBMI (all P < 0.05). Conclusions High adiposity without high BMI is more common than BMI‐defined obesity in older Swedish adults but does not provide similar protection from osteoporosis and sarcopenia.

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Increased postural sway during quiet stance as a risk factor for prospective falls in community-dwelling elderly individuals

Abstract: objective measures of postural sway independently predict incident falls in older community-dwelling men and women. Further studies are needed to evaluate whether postural sway length is of interest for the prediction of incident falls in clinical settings.

Cited by 137 publications

References 29 publications

Postural sway normative data across the adult lifespan: Results from 6280 individuals on the Balance Tracking System balance test

Postural sway normative data across the adult lifespan: Results from 6280 individuals on the Balance Tracking System balance test

Ankle flexor/extensor strength and muscle density are complementary determinants of balance during dual‐task engagement: The ankle quality study

Adiposity Without Obesity: Associations with Osteoporosis, Sarcopenia, and Falls in the Healthy Ageing Initiative Cohort Study

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