Aims: Balance and strength performance may predict morbidity and mortality in older people. We aimed to compare the associations of balance and strength performance with all-cause and cause-specific mortality.
Methods: We analysed data from 1335 older men from the Western Australian Health in Men cohort study. Predictive variables included strength (knee extension test) and balance measures (modified Balance Outcome Measure for Elder Rehabilitation (mBOOMER) Score), derived from baseline physical assessments (2011-2013). Outcome measures included all-cause, cardiovascular, and cancer mortality, ascertained via the Western Australian Data Linkage System death registry. Data were analysed using Cox proportional hazards regression models adjusting for: education, cohabitation, socioeconomic status, alcohol use, smoking, physical activity, sleep, cognition, blood pressure, body mass index, and prevalent cancer or cardiovascular disease.
Results: Mean (SD) age was 84.5 (3.4) years and 473 (35.4%) participants died before end of follow-up (December 2017). Better performance on both the mBOOMER score and knee extension test was associated with lower risk of all-cause (HR: 0.83, 95% CI: 0.80-0.87 and HR: 0.96, 95% CI: 0.95-0.98 respectively) and cardiovascular mortality (HR: 0.82, 95% CI: 0.77-0.87 and HR: 0.96, 95% CI: 0.94-0.98 respectively). Better mBOOMER score performance was associated with lower risk of cancer mortality (HR: 0.90, 95% CI: 0.83-0.98) only when adjusting for prevalent cancer.
Conclusions: Poorer performance in both strength and balance is associated with greater risk of all-cause and cardiovascular mortality. These results clarify the relationship of balance with cause-specific mortality and encourage investigation of any mortality benefit from both balance and strength interventions.