POSTURAL STABILITY, FALLS AND FRACTURES IN THE ELDERLY - RESULTS FROMTHE DUBBO OSTEOPOROSIS EPIDEMIOLOGY STUDY

Objective: To assess measures of postural stability in a large populat ion of persons aged over 60 years in order to compare performance betw een fallers and non-fallers and relate postural stability to fracture prevalence. Methods: The sensorimotor, visual and balance functions we re measured in 1762 ambulatory, community-dwelling patients aged betwe en 60 and 100 years (mean age, 70.1 years) living in a large semiurban Australian city. A history of recent falls and fractures was recorded at the time of assessment. Results: The prevalence of impairment in a ll tests increased with age. Men performed significantly better than w omen in tests of muscle strength, visual field dependence, sway on the floor with eyes open and dynamic balance. In the 12 months before tes ting, 72.3% of the patients experienced no falls, 18.4% fell only once and 9.3% fell on two or more occasions. Multiple fallers had weaker q uadriceps, poorer tactile sensitivity, greater visual field dependence and greater body sway than other patients. Test scores for once-only fallers were mostly between those for non-fallers and multiple fallers . Those who suffered recent fall-related fractures had significantly r educed tactile sensitivity and quadriceps strength and increased body sway. Postural stability was also impaired in patients taking psychoac tive and/or antihypertensive medications. Conclusion: Tests of postura l stability can identify, independently of age, individuals living in the community who are at risk of falls and fall-related fractures.