McMullan Ilona I, Bunting Brendan P, McDonough Suzanne M, Tully Mark A, Casson Karen
UKCRC Centre of Excellence for Public Health (NI), Ulster University, UK.
Institute of Nursing and Health Research, Ulster University, UK.
J Frailty Sarcopenia Falls. 2019 Dec 1;4(4):102-110. doi: 10.22540/JFSF-04-102. eCollection 2019 Dec.
Falls due to poor balance can cause injury, disability, and death in older adults. The relationship between free-living physical activity (PA) and balance over time is poorly understood. The aim of this study is to explore the association between PA and balance in older adults over time.
Using two waves of data from the TILDA study (n=8,504 participants) a structural equation model was used to identify a composite measure of balance that incorporated measures of Timed Up and Go; handgrip strength; Mini Mental State Exam; vision; hearing; and steadiness. The patterns of change in PA and balance were then compared over time (controlling for covariates).
The results showed that one extra metabolic equivalent of task (MET) minute of PA improves balance by 4% over one week (Est=-0.10, SE=0.12), and by 5% cumulatively over two years (Est=-0.13, SE=0.02). Medication, alcohol consumption, sex, age, fear of falling, education, pain, and problems performing activities of daily living (ADL) were risk factors for balance.
This study provides a novel and robust model that should guide comprehensive balance assessment. PA promotion should engage older adults in more free-living PA that may be more relevant to them.
因平衡能力差导致的跌倒会致使老年人受伤、残疾甚至死亡。人们对日常身体活动（PA）与平衡能力随时间变化之间的关系了解甚少。本研究旨在探讨老年人PA与平衡能力之间随时间变化的关联。
利用来自爱尔兰老年纵向研究（TILDA研究）两期的数据（n = 8504名参与者），采用结构方程模型来确定一个综合平衡指标，该指标纳入了计时起立行走测试、握力、简易精神状态检查表、视力、听力和平衡能力测试等测量指标。然后比较PA和平衡能力随时间的变化模式（控制协变量）。
结果显示，每周增加1代谢当量任务（MET）分钟的PA，平衡能力提高4%（估计值=-0.10，标准误=0.12），两年累计提高5%（估计值=-0.13，标准误=0.02）。用药情况、饮酒量、性别、年龄、跌倒恐惧、教育程度、疼痛以及日常生活活动（ADL）执行问题均为平衡能力的风险因素。
本研究提供了一个新颖且可靠的模型，应可指导全面的平衡评估。促进PA应让老年人参与更多与其可能更相关的日常PA。
