An Investigation of the association between physical activity and balance in older adults

Abstract

Balance is critical for health and well-being, but the ageing process is a key risk factor for poor balance which may lead to falls, disability, and death in older adults. The benefits of physical activity (PA) are recognised in policy and guidelines for fall prevention, where moderate to vigorous PA (MVPA) is recommended for the general population, and balance and co-ordination exercise is recommended for adults at higher risk of falling (≥65 years). Global adherence to PA guidelines is low, and older adults are more likely to engage in low intensity PA (LPA). However, less is understood regarding its benefits for balance. Furthermore, PA and balance assessment is complex where selfreported measures are subject to bias and guidance on which combination of indirect balance measures is appropriate is lacking. This thesis aims to contribute to the understanding of the relationship between PA and balance in older adults (≥50 years). A systematic review of the existing literature identified that free-living PA defined as activity for leisure, occupational, and travel was associated with better balance in healthy older adults. A Structural Equation Modelling (SEM) approach using data from the Irish Longitudinal Ageing study (TILDA), and the English Longitudinal Study of Ageing (ELSA) showed that multiple indirect measures provided effective balance assessment; that balance declined by 25%-29% over time; that PA was beneficial to balance where an extra Metabolic Equivalent minute per week improved balance by 5% over two years; that MVPA improved balance in older adults ≤70 years and slowed the rate of decline; and that LPA XIV improved balance in older adults ≥70 years. An investigation into the robustness and generalisability of the results using the Northern Irish Cohort of Longitudinal Ageing (NICOLA) confirmed that the findings from TILDA or ELSA can be generalised to other studies of ageing.

Date of Award	Jan 2019
Original language	English
Supervisor	Brendan Bunting (Supervisor), Suzanne Mc Donough (Supervisor), K. Casson (Supervisor) & Mark Tully (Supervisor)