Difficulties with balance are associated with limitations in activities of daily living. There is little information, however, about the epidemiology of imbalance. Imbalance, defined as the inability to maintain a full-tandem stand for 10 seconds, was assessed as part of an interview with 2,018 residents of Mann County, California, age 55 and older. The likelihood of imbalance was greater in women, those aged 85 and older, and those with less than 12 years of education. It was also associated with specific chronic conditions, including a history of hypertension, stroke, or cataracts. Even after adjusting for these conditions, imbalance was associated with reduced lower-body strength as well as poor short-term memory, hip pain, vision problems, abstention from alcohol, and current cigarette smoking. With those aged 85 and older representing the fastest growing age group in developed nations, imbalance may become a major health problem.
Get full access to this article
View all access options for this article.
References
1.
Ahlsio, B. , Briton, M., Murray, V., & Theorell, T. (1984). Disablement and quality of life after stroke. Stroke, 15, 886-890.
2.
Aho, K. , Harmsen, P., Hatano, S., Marquardsen, J., Smirnov, V. E., & Strassen, T. (1980). Cerebrovascular disease in the community: Results of a WHO collaborative study. Bulletin of the World Health Organization, 58, 113-130.
3.
Albert, M. , Smith, L. A., Scherr, P. A., Taylor, J. O., Evans, D. A., & Funkenstein, H. H. (1991). Use of brief cognitive tests to identify individuals in the community with clinically diagnosed Alzheimer's Disease. International Journal of Neurology, 57, 167-178.
4.
Baker, S. , O'Neill, B., & Karpf, R. S. (1984). Injury factbook. Lexington, MA: Lexington Books.
5.
Berkman, L. , & Breslow, L. (1983). Health and ways of living. New York: Oxford University Press.
6.
Blake, A. J. , Morgan, K., Bendall, M. J., Dallosso, H., Ebrahim, S.B.J., Arie, T.H.D., Fentem, P. H., & Bassey, I. J. (1988). Falls by elderly people at home: Prevalence and associated factors. Age and Ageing, 17, 365-372.
7.
Buchner, D. M. , Hombrook, M. C., Kutner, N. G., Tinetti, M. E., Ory, M. G., Mulrow, C. D., Schechtman, K. B., Gerety, M. B., Fiatarone, M. A., Wolf, S. L., Rossiter, J., Artken, C., Kanten, K., Lipsitz, L. A., Sattin, R. W., DeNino, L. A., & FICSIT Group. (1993). Development of the common data base for the FICSIT trials. Journal of the American Geriatrics Society, 41, 297-308.
8.
Cornoni-Huntley, J. , Brock, D., Ostfeld, A. M., Taylor, J. O., & Wallace, R. B. (1986). Established populations for epidermiologic studies of the elderly: Resource data book (NIH Publication No. 86-2443). Washington, DC: US Department of Health and Human Services.
9.
Cox, D. R. (1970). The analysis of binary data. London: Methuen.
10.
Fleiss, J. L. (1981). Statistical methods for rates and proportions. New York: John Wiley.
11.
George, L. K. (1992). Social factors and the onset and outcome of depression. In K. W. Schaie, D. Blazer, & J. S. House (Eds.), Aging, health behaviors, and health outcomes (pp. 137-159). Hillsdale, NJ: Lawrence Erlbaum.
12.
Gerson, L. W. , Jarjoura, D., & McCord, G. (1989). Risk of imbalance in elderly people with impaired hearing or vision. Age and Ageing, 18, 31-34.
13.
Gilford, D. M. (Ed.) (1988). The aging population in the twenty-first century: Statistics for health policy. Washington, DC: National Academy Press.
14.
Guralnik, J. M. , Branch, L. G., Cummings, S. R., & Curb, J. D. (1989). Physical performance measures in aging research. Journal of Gerontology, 44, M141-M146.
15.
Guralnik, J. M. & Kaplan, G. A. (1989). Predictors of healthy aging: Prospective evidence from the Alameda County Study. American Journal of Public Health, 79, 703-708.
16.
Guralnik, J. M. , LaCroix, A. Z., Abbot R. D., Berkman, L. F., Satterfield, S., Evans, D. A., & Wallace, R. B. (1993). Maintaining mobility in late life: 1 demographic characteristics and chronic conditions. American Journal of Epidemiology, 137, 845-857.
17.
Guralnik, J. M. , Simonsick, E. M., Ferrucci, L., Glynn, R. J., Berkman, L. F., Blazer, D. G., Scherr, P. A., & Wallace, R. B. (1994). A short physical performance battery assessing lower extremity function: Association with self-reported disability and prediction of mortality and nursing home admission. Journal of Gerontology, 49, M85-M94.
18.
Harris, T. , Kovar, M. G., Suzman, R., Kleinman, J. C., & Feldman, J. J. (1989). Longitudinal study of physical ability in the oldest-old. American Journal of Public Health, 79, 698-702.
19.
House, J. S. , Kessler, R. C., & Herzog, A. R. (1990). Age, socioeconomic status, and health. Milbank Quarterly, 68, 383-411.
20.
House, J. S. , Kessler, R. C., Herzog, A. R., Mero, R. P., Kinney, A. M., & Breslow, M. J. (1992). Stratification, age and health. In K. W. Schaie, D. Blazer, & J. S. House (Eds.), Aging, health behaviors, and health outcomes (pp. 1-32). Hillsdale, NJ: Lawrence Erlbaum.
21.
Jette, A. M. , Pinsky, J. L., Branch, L. G., Wolf, P. A., & Feinleib, M. (1988). The Framingham Disability Study: Physical disability among community-dwelling survivors of stroke. Journal of Clinical Epidemiology, 41, 719-726.
22.
Katz, S. , Branch, L. G., Branson, M. H., Papsidero, J. A., Beck, J. C., & Greer, D. S. (1983). Active life expectancy. New England Journal of Medicine, 309, 1218-1224.
23.
Kelsey J. L. , O'Brien, L. A., Grisso, J. A., & Hoffman, S. (1989). Issues in carrying out epidemiologic research in the elderly. American Journal of Epidemiology, 130, 857-866.
24.
LaCroix, A. Z. , Guralnik, J. M., Berkman, L. F., Wallace, R.B., & Satterfield, S. (1993). Maintaining mobility in late life: 2 smoking, alcohol consumption, physical activity, and body mass index. American Journal of Epidemiology, 137, 858-869.
25.
Manton, K. G. , & Soldo, B. J. (1992). Disability and mortality among the oldest old: Implications for current and future health and long-term care service needs. In R. M. Suzman, D. P. Willis, & K. G. Manton (Eds.), The oldest old (pp. 199-250). New York: Oxford University Press.
26.
Marmot, M. G. , Kogevinas, M., & Elston, M. A. (1987). Social/economic status and disease. Annual Review of Public Health, 8, 111-135.
27.
Mor, V. , Murphy, J., Masterson-Allen, S., Willey, C., Razmpour, A., Jackson, M. E., Greer, D., & Katz, S. (1989). Risk of functional decline among well elders. Journal of Clinical Epidemiology, 42, 521-529.
28.
Nelson, H. D. , Nevitt, M. C., Scott, J. C., Stone, K. L., & Cummings, S. R. (1994) Smoking, alcohol, and neuromuscular and physical function of older women. Journal of the American Medical Association, 272, 1825-1831.
29.
Ory, M. G. , Schechtman, K. B., Miller, J. P., Hadley, E. C., Fiatarone, M. A., Province, M. A., Arfken, C. L., Morgan, D., Weiss, S., Kaplan, M., & the FICSIT Group. (1993). Frailty and injuries in later life: The FISCIT trials. Journal of the American Geriatrics Society, 41, 283-296.
30.
Pinsky, J. L. , Leaverton, P. E., & Stokes, J. (1987). Predictors of good function: The Framingham Study. Journal of Chronic Diseases, 40 (Suppl), 159S-167S.
31.
Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385-401.
32.
Reed, D. , Satariano, W. A., Gildengorin, G., McMahon, K., Fleshman, R., & Schneider, E. (1995). Health and functioning among the elderly of Marin County, California: A glimpse of the future. Journal of Gerontology, 50A, M61-M69.
33.
Scherr, P. , Albert, M., Funkenstein, H., Cook, N. R., Hennekens, C. H., Branch, L. G., White, L. R., Taylor, J. O., & Evans, D. A. (1988). Correlates of cognitive function in an elderly community population. American Journal of Epidemiology, 128, 1084-1101.
34.
Schneider, E. L. , & Guralnik, J. M. (1990). The aging of America: Impact on health care costs. Journal of the American Medical Association, 263, 2335-2340.
35.
Siegal, J. S. (1993). A generation of change: A profile of America's older population. New York: Russell Sage Foundation.
36.
Suzman, R. M. , Willis, D. P., & Manton, K. G. (Eds.). (1992). The oldest old. New York: Oxford University Press.
37.
Tinetti, M. E. (1986). Performance-oriented assessment of mobility problems in elderly patients. Journal of the American Geriatrics Society, 34, 119-126.
38.
Tinetti, M. E. , Baker, D. I., McAvay, G., Claus, E. B., Garrett, P., Gottschalk, M., Koch, M. L., Trainor, K., & Horwitz, R. I. (1994). A multifactorial intervention to reduce the risk of falling among elderly people living in the community. New England Journal of Medicine, 331, 821-827.
39.
Tinetti, M. E. , Speechley, M., & Ginter, S. F. (1988). Risk factors for falls among elderly persons living in the community. New England Journal of Medicine, 319, 1701-1707.
40.
Tobias, J. S. , & Reinsch, S. (1989). Postural instability in the elderly: Contributing factors and suggestions for rehabilitation. Physical and Rehabilitation Medicine, 1, 59-65.
41.
Weindruch, R. , Korper, S. P., & Hadley, E. (1989). The prevalence of disequilibrium and related disorders in older persons. Ear, Nose and Throat Journal, 68, 925-929.
42.
Wolfson, L. T. , Whipple, R., & Amerman, P. (1986). Stressing the postural response: A quantitative method for testing balance. Journal of the American Geriatrics Society, 34, 845-850.
43.
Wolfson, L. T. , Whipple, R., Judge, J., Amerman, P., Derby, C., & King, M. (1993). Training balance and strength in the elderly to improve function. Journal of the American Geriatrics Society, 41, 341-343.
