Perceived Balance Predicts Falls in Community-Dwelling Older Adults: A Longitudinal Study Using the National Health and Aging Trend Study Data.

Background and objectives: Falls are an increasing problem among older adults. Older adults' self-report of falls is the primary method of fall risk identification. However, up to 72% of Medicare beneficiaries who have fallen do not report falls and fall-related injuries to their healthcare providers. Research suggests that older adults prefer the term "balance problems" instead of "fall risk." The purpose of this study was to examine if perceived balance problem is a predictor of self-reported falls after controlling for known predictors of falls among older adults.

Research design and methods: The Health Belief Model served as the theoretical framework. A longitudinal secondary analysis was conducted using data from a subsample of independently living participants (N = 5,446) from the National Health and Aging Trends Study. Baseline data was from the year 2015, and the outcome was self-reported falls in 2016.

Results: Complex samples multiple logistic regression analyses revealed that the single item perceived balance problem question (odds ratios, OR = 1.69, p < .001) predicted falls in 2016, whereas, the balance performance measure, Short Physical Performance Battery, did not (OR = 0.98, p = .06). Non-Hispanic White participants were more likely to report falling compared to non-Hispanic Black and Hispanic participants, as were females compared to males. A hospital stay in 2015, comorbidities, fear of falling, and a fall in 2015 were also predictive of falls.

Discussion and implications: Assessing older adults' perceived balance is important in primary care to identify fall risk and recommend appropriate home modifications, assistive devices, and/or interventions.