81 Balance Ability and Falls in Mid-Life: Understanding Associations and Potential Diagnostic Screening

Abstract Background Falls in older adults are a growing public health concern. Evidence shows that balance ability is associated with falls and may be a useful screening tool to identify high-risk individuals. However, research has primarily focused on individuals aged 65+. This evidence has used regression modeling, without assessing the diagnostic accuracy of balance. We aimed to investigate both associations and screening accuracy of balance ability at ages 53 and 60-64 with falls at ages 60-64 and 68. Methods Data from the MRC National Survey of Health and Development, a British birth cohort study, were utilised (n=3563). At ages 53 and 60-64, one-legged balance time with eyes-closed was assessed. At ages 60-64 and 68, participants self-reported fall frequency (0, 1, 2+) and type (injurious, non-injurious) within the last year. Sex-adjusted multinomial logistic regressions assessed associations of balance with fall frequency and type. Areas under the curve (AUCs) of balance and sex prediction models were calculated. Results Better balance ability at age 53 was associated with lower risk of recurrent falls at ages 60-64 [RRR(95%CI) of 0.97(0.94,1.00)] and 68 [0.97(0.94,0.99)], and balance at age 60-64 was associated with risk of recurrent falls at age 68 [0.92(0.88,0.97)]. Higher balance at age 53 was associated with injurious falls at age 60-64 [0.95(0.92,0.99)], while higher balance at age 60-64 was associated with non-injurious falls in women [0.90(0.85,0.96)]. AUCs for all models remained low (<0.650); the addition of balance to a sex-only model improved diagnostic accuracy for recurrent and injurious falls. Conclusions Balance and falls are associated, even at younger ages. The poor discriminatory ability of balance tests suggests that it may not be an appropriate tool to identify those at risk of falling. Despite an underlying aetiological association between balance and falls, further translational research is needed before balance screenings are implemented into primary care.