Postural stability, falls and fractures in the elderly: results from the Dubbo Osteoporosis Epidemiology Study

Abstract

Objective: To assess measures of postural stability in a large population of persons aged over 60 years in order to compare performance between fallers and non-fallers and relate postural stability to fracture prevalence.

Methods: The sensorimotor, visual and balance functions were measured in 1762 ambulatory, community-dwelling patients aged between 60 and 100 years (mean age, 70.1 years) living in a large semi-urban Australian city. A history of recent falls and fractures was recorded at the time of assessment.

Results: The prevalence of impairment in all tests increased with age. Men performed significantly better than women in tests of muscle strength, visual field dependence, sway on the floor with eyes open and dynamic balance. In the 12 months before testing, 72.3% of the patients experienced no falls, 18.4% fell only once and 9.3% fell on two or more occasions. Multiple fallers had weaker quadriceps, poorer tactile sensitivity, greater visual field dependence and greater body sway than other patients. Test scores for once-only fallers were mostly between those for non-fallers and multiple fallers. Those who suffered recent fall-related fractures had significantly reduced tactile sensitivity and quadriceps strength and increased body sway. Postural stability was also impaired in patients taking psychoactive and/or anti-hypertensive medications.

Conclusion: Tests of postural stability can identify, independently of age, individuals living in the community who are at risk of falls and fall-related fractures.