Associations between Balance Measures and Risk of Fractures in 70-Year-Old Individuals: A Population-Based Cohort Study.

Context: There are uncertainties regarding to what extent poor vision and distracting tasks reduce balance and associate with fracture risk.
Objective: To investigate the associations between body sway assessed under different visual and multitasking conditions and later risk of fractures in older adults.
Design: Cohort study.
Setting: Umeå municipality, Sweden.
Patients or Other Participants: N=5,437 community-dwelling 70-year-old individuals who participated in a population-based health examination.
Main Outcome Measure: Body sway at baseline was measured using a Wii balance board in the lateral and anterior-posterior direction during three different tests, including with eyes open, dual-tasking, and eyes closed. Fractures during follow-up were ascertained using nationwide registers.
Results: During a mean (range) follow-up of 4.8 (0.0-10.6) years, 348 women (12.3%) and 149 men (5.7%) sustained a fracture. In women, both anterior-posterior sway velocity (hazard ratio [HR], 1.05 95% CI, 1.01-1.08, per mm/s increase) and variation in sway velocity (HR, 1.05, 95% CI, 1.01-1.09, per standard deviation [SD] increase) during dual-tasking testing were associated with higher risk of fracture after adjustment for covariates. During testing with eyes closed, all measures of lateral sway were associated with the risk of fracture (P<0.01 for all). In men, variation in lateral (HR, 1.03, 95% CI, 1.00-1.07 per SD increase) and anterior-posterior sway velocity (HR 1.05, 95% CI, 1.01-1.10 per SD increase) during dual-tasking testing were associated with higher risk of fracture.
Conclusions: Higher body sway velocity and larger variation in sway velocity were associated with higher risk of fractures in both 70-year-old men and women, especially under more challenging testing conditions.
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