Comparison of the Diagnostic Accuracy of Common Balance Measurement Tools in Community-Dwelling Older Adults

Balance screening has been identified as a major predictor of falls in the elderly. The current study compares the diagnostic accuracy of various balance instruments in community-dwelling older adults.

In this cross-sectional study, 145 older adults were recruited. The Berg balance scale (BBS), Fullerton advanced balance (FAB) scale, dynamic gait index (DGI), performance-oriented mobility assessment (POMA), timed up and go (TUG) test, gait speed, step length, step test, and single item question were administered. The receiver operating characteristics curve analysis was used to calculate diagnostic accuracy.

All single-item tools had moderate diagnostic accuracy (area under the curve [AUC]=0.76-0.89) and all multi-item tools had high diagnostic accuracy (AUC=0.91-0.95) when using the recommended cut-off point of 45 for BBS. All multi-item tools maintained high to moderate diagnostic accuracy (AUC=0.85-1.00) in all thresholds while using BBS severity cut-off points. The FAB scale showed the highest diagnostic accuracy (AUC=0.95) among all assessment tools. Single-item question scores (Wald=22.61, df=1, P=0.0001, Exp(B)=8.82) were significant as covariates in the regression model.

For older adults with or without a history of falling, the FAB scale demonstrated the highest diagnostic accuracy. Along with single-item tools, the FAB scale may be a preferred multi-item tool.