Program in Physical Therapy, Washington University School of Medicine, St Louis, Missouri.
Doctor of Physical Therapy Division, Department of Orthopedics, Duke University School of Medicine, Durham, North Carolina.
JAMA Otolaryngol Head Neck Surg. 2021 May 1;147(5):460-468. doi: 10.1001/jamaoto.2021.0057.
Difficulty maintaining balance is common among individuals aged 40 years or older and increases the risk of falls. However, little is known about the association of balance function with long-term mortality outcomes in adults.
To investigate the association of balance function with all-cause and cause-specific mortality among US adults.
DESIGN, SETTING, AND PARTICIPANTS: A prospective, population-based cohort study of a nationally representative sample of 5816 adults (weighted population, 92 260 641) from the US National Health and Nutrition Examination Survey was conducted from 1999 to 2004. Individuals aged 40 years or older who completed the modified Romberg Test of Standing Balance on Firm and Compliant Support Surfaces were included. Participants were linked to mortality data from the test date through December 31, 2015. Data analysis was conducted from February 1 to June 1, 2020.
The modified Romberg Test of Standing Balance on Firm and Compliant Support Surfaces was used to measure balance function and define balance disorder according to sensory input.
Mortality associated with all causes, cardiovascular disease (CVD), and cancer.
A total of 5816 adults (weighted mean [SE] age, 53.6 [0.2] years; 2897 [49.8%] women) were included in this cohort study. During up to 16.8 years of follow-up (median, 12.5 years; 68 919 person-years), 1530 deaths occurred, including 342 associated with CVD and 364 associated with cancer. Participants with balance disorder were at a higher risk of death from all causes, CVD, and cancer. After adjusting for sociodemographic characteristics, lifestyle factors, and chronic conditions, the hazard ratios (HRs) among participants with balance disorder compared with those without balance disorder were 1.44 (95% CI, 1.23-1.69) for all-cause mortality, 1.65 (95% CI, 1.17-2.31) for CVD mortality, and 1.37 (95% CI, 1.03-1.83) for cancer mortality. Furthermore, vestibular balance disorder was associated with increased mortality from all causes (HR, 1.31; 95% CI, 1.08-1.58), CVD (HR, 1.59; 95% CI, 1.12-2.27), and cancer (HR, 1.39; 95% CI, 1.04-1.86).
In this nationally representative sample of US adults, balance disorder was associated with an increased risk of all-cause, CVD, and cancer mortality. Further studies are needed to confirm these findings and evaluate whether the observed associations represent a causal biological phenomenon and, if so, whether the effect is modifiable with a multicomponent exercise program.
平衡障碍在 40 岁或以上的人群中很常见，并且会增加跌倒的风险。然而，对于平衡功能与成年人长期死亡率结果之间的关联，我们知之甚少。
调查美国成年人的平衡功能与全因和特定原因死亡率之间的关系。
设计、地点和参与者：这是一项在美国全国健康和营养检查调查中具有全国代表性的 5816 名成年人（加权人口为 92260641 人）的前瞻性、基于人群的队列研究。研究纳入了在坚固和顺应性支撑表面上完成改良 Romberg 站立平衡测试的年龄在 40 岁或以上的个体。参与者根据测试日期与死亡率数据相关联，截至 2015 年 12 月 31 日。数据分析于 2020 年 2 月 1 日至 6 月 1 日进行。
使用改良 Romberg 站立平衡测试在坚固和顺应性支撑表面上测量平衡功能，并根据感觉输入定义平衡障碍。
全因、心血管疾病 (CVD) 和癌症相关的死亡率。
这项队列研究共纳入了 5816 名成年人（加权平均[SE]年龄为 53.6[0.2]岁；2897[49.8%]名女性）。在最长 16.8 年的随访期间（中位数为 12.5 年；68919 人年），发生了 1530 例死亡，包括 342 例与 CVD 相关和 364 例与癌症相关。有平衡障碍的参与者全因、心血管疾病和癌症死亡的风险更高。在调整了社会人口统计学特征、生活方式因素和慢性疾病后，与无平衡障碍的参与者相比，有平衡障碍的参与者的全因死亡率的危险比（HR）为 1.44（95%CI，1.23-1.69），心血管疾病死亡率的 HR 为 1.65（95%CI，1.17-2.31），癌症死亡率的 HR 为 1.37（95%CI，1.03-1.83）。此外，前庭平衡障碍与全因死亡率（HR，1.31；95%CI，1.08-1.58）、心血管疾病死亡率（HR，1.59；95%CI，1.12-2.27）和癌症死亡率（HR，1.39；95%CI，1.04-1.86）的增加相关。
在这项具有全国代表性的美国成年人样本中，平衡障碍与全因、心血管疾病和癌症死亡率的风险增加有关。需要进一步的研究来证实这些发现，并评估观察到的关联是否代表因果生物学现象，如果是，这种影响是否可以通过多组分运动方案来改变。
