One-legged balance performance and fall risk in mid and later life: longitudinal evidence from a British birth cohort

Introduction: The one-legged balance test is widely used as a fall risk screening tool in both clinical and research settings. Despite rising fall prevalence in midlife, there is little evidence examining balance and fall risk in those aged <65 years. This study investigated the longitudinal associations between one-legged balance and the number of falls between ages 53 and 68 years. Methods: The study included 2,046 individuals from the Medical Research Council National Survey of Health & Development, a British birth cohort study. One-legged balance times (eyes open, maximum: 30 seconds) were assessed at ages 53 years (1999) and 60–64 years (2006–2010). Fall history within the last year (none, 1, ≥2) was self-reported at ages 60–64 years and 68 years (2014). Multinomial logistic regressions assessed the associations between balance and change in balance with subsequent falls. Models adjusted for anthropometric, socioeconomic, behavioral, health status, and cognitive indicators. Analysis occurred between 2019 and 2022. Results: Balance performance was not associated with single falls. Better balance performance at age 53 years was associated with decreased risk of recurrent falls at ages 60–64 years and 68 years, with similar associations between balance at age 60–64 years and recurrent falls at age 68 years. Those with consistently lower balance times (<15 seconds) were at greater risk (RRR=3.33, 95% CI=1.91, 5.80) of recurrent falls at age 68 years in adjusted models than those who could balance for 30 seconds at ages 53 years and 60–64 years. Conclusions: Lower balance and consistently low or declining performance were associated with a greater subsequent risk of recurrent falls. Earlier identification and intervention of those with poor balance ability can help to minimize the risk of recurrent falls in aging adults.