Factors Associated With Balance Confidence in Older Adults With Health Conditions Affecting the Balance and Vestibular System

Marchetti GF, Whitney SL, Redfern MS, Furman JM. Factors associated with balance confidence in older adults with health conditions affecting the balance and vestibular system.ObjectiveTo determine the functional, clinical, and comorbid health condition factors that contribute to balance confidence in persons with balance or vestibular disorders, or both.DesignCross-sectional descriptive.SettingTertiary care center for balance disorders.ParticipantsOlder adults (N=95) with signs and symptoms of vestibular dysfunction.InterventionsNot applicable.Main Outcome MeasuresActivity-specific Balance Confidence Scale (ABC) was administered on examination for complaints of balance, postural instability, or both.ResultsBalance confidence as measured by the ABC was associated with functional balance performance on the Timed Up & Go test and the Dynamic Gait Index. Duration of symptoms and general health-related quality of life (as measured by the Medical Outcomes Study 36-Item Short-Form Health Survey) were significant covariates of balance confidence. Self-reported treatment for anxiety, depression, or both, significantly reduced balance confidence.ConclusionsBalance confidence is a complex construct in older adults with signs and symptoms of balance or vestibular dysfunction, or both. Decreased balance confidence in performing functional activities is associated with actual balance performance, duration of vestibular symptoms, general health-related quality of life, and the presence of comorbid psychological and visual impairments. Understanding these relationships can potentially improve management of older adults who present with balance or vestibular disease, or both.