Blodgett Joanna M, Cooper Rachel, Davis Daniel H J, Kuh Diana, Hardy Rebecca
MRC Unit for Lifelong Health and Ageing at UCL, London, United Kingdom.
Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, United Kingdom.
Front Sports Act Living. 2020 Apr 7;2020:00028. doi: 10.3389/fspor.2020.00028.
Despite its associations with falls, disability, and mortality, balance is an under-recognized and frequently overlooked aspect of aging. Studies investigating associations between factors across life and balance are limited. Understanding the factors related to balance performance could help identify protective factors and appropriate interventions across the life course. This study aimed to: (i) identify socioeconomic, anthropometric, behavioral, health, and cognitive factors that are associated with one-legged balance performance; and (ii) explore how these associations change with age.
Data came from 3,111 members of the MRC National Survey of Health and Development, a British birth cohort study. Multilevel models examined how one-legged standing balance times (assessed at ages 53, 60-64, and 69) were associated with 15 factors across life: sex, maternal education (4 years), paternal occupation (4 years), own education (26 years), own occupation (53 years), and contemporaneous measures (53, 60-64, 69 years) of height, BMI, physical activity, smoking, diabetes, respiratory symptoms, cardiovascular events, knee pain, depression and verbal memory. Age and sex interactions with each variable were assessed.
Men had 18.8% (95%CI: 13.6, 23.9) longer balance times than women at age 53, although this difference decreased with age (11.8% at age 60-64 and 7.6% at age 69). Disadvantaged socioeconomic position in childhood and adulthood, low educational attainment, less healthy behaviors, poor health status, lower cognition, higher body mass index (BMI), and shorter height were associated with poorer balance at all three ages. For example, at age 53, those from the lowest paternal occupational classes had 29.6% (22.2, 38.8) worse balance than those from the highest classes. Associations of balance with socioeconomic indicators, cognition and physical activity became smaller with age, while associations with knee pain and depression became larger. There were no sex differences in these associations. In a combined model, the majority of factors remained associated with balance.
This study identified numerous risk factors across life that are associated with one-legged balance performance and highlighted diverse patterns of association with age, suggesting that there are opportunities to intervene in early, mid and later life. A multifactorial approach to intervention, at both societal and individual levels, may have more benefit than focusing on a single risk factor.
尽管平衡与跌倒、残疾和死亡率相关，但它在衰老过程中是一个未得到充分认识且经常被忽视的方面。研究生命各阶段因素与平衡之间关联的研究有限。了解与平衡能力相关的因素有助于识别生命历程中的保护因素和适当干预措施。本研究旨在：（i）识别与单腿平衡能力相关的社会经济、人体测量、行为、健康和认知因素；（ii）探讨这些关联如何随年龄变化。
数据来自英国一项出生队列研究——医学研究委员会全国健康与发展调查的3111名成员。多水平模型研究了单腿站立平衡时间（在53岁、60 - 64岁和69岁时评估）与生命各阶段的15个因素之间的关联：性别、母亲教育程度（4年）、父亲职业（4年）、自身教育程度（26年）、自身职业（53年）以及同时期（53岁、60 - 64岁、69岁）的身高、体重指数（BMI）、身体活动、吸烟、糖尿病、呼吸道症状、心血管事件、膝关节疼痛、抑郁和言语记忆测量值。评估了年龄和性别与每个变量的交互作用。
53岁时，男性的平衡时间比女性长18.8%（95%置信区间：13.6，23.9），不过这种差异随年龄减小（60 - 64岁时为11.8%，69岁时为7.6%）。儿童期和成年期社会经济地位不利、教育程度低、健康行为较少、健康状况差、认知能力较低、体重指数（BMI）较高以及身高较矮在所有三个年龄段都与较差的平衡能力相关。例如，53岁时，父亲职业阶层最低的人群比最高阶层的人群平衡能力差29.6%（22.2，38.8）。平衡能力与社会经济指标、认知和身体活动的关联随年龄减小，而与膝关节疼痛和抑郁的关联则增大。这些关联不存在性别差异。在一个综合模型中，大多数因素仍与平衡能力相关。
本研究识别了生命各阶段中与单腿平衡能力相关的众多风险因素，并突出了与年龄相关的不同关联模式，表明在生命早期、中期和后期都有干预机会。在社会和个体层面采取多因素干预方法可能比专注于单一风险因素更有益。
