Assessment of balance and risk for falls in a sample of community-dwelling adults aged 65 and older

BACKGROUND Falls are a major health concern for older adults and their impact is a significant public health problem. The chief modifiable risk factors for falls in community-dwellers are psychotropic drugs, polypharmacy, environmental hazards, poor vision, lower extremity impairments, and balance impairments. This study focused on balance impairments. Its purpose was to assess the feasibility of recruiting older adults with possible balance problems for research conducted at a chiropractic research center, and to explore the utility of several widely used balance instruments for future studies of the effect of chiropractic care on balance in older adults. METHODS This descriptive study was conducted from September through December 2004. Participants were recruited through a variety of outreach methods, and all were provided with an educational intervention. Data were collected at each of two visits through questionnaires, interviews, and physical examinations. Balance was assessed on both visits using the Activities-specific Balance Confidence Scale (ABCS), the Berg Balance Scale (BBS), and the One Leg Standing Test (OLST). RESULTS A total of 101 participants enrolled in the study. Advertising in the local senior newspaper was the most effective method of recruitment (46%). The majority of our participants were white (86%) females (67%). About one third (32%) of participants had a baseline BBS score below 46, the cut-off point for predicting risk of falling. A mean improvement in BBS scores of 1.7 points was observed on the second visit. For the subgroup with baseline scores below 46, the mean change was 4.5 points, but the group mean remained below 46 (42.5). CONCLUSION Recruitment of community-dwelling seniors for fall-related research conducted at a chiropractic research center appears feasible, and the most successful recruitment strategies for this center appeared to be a combination of targeted newspaper ads and personal contact through senior centers. The BBS and OLST appear to be promising screening and assessment instruments, which might have utility in future investigations of the possible effects of chiropractic care on balance.