INFLUENCE OF BALANCE ABILITY, BALANCE CONFIDENCE, AND PHYSICAL ACTIVITY ON HEALTH-RELATED QUALITY OF LIFE IN ELDER PERSONS. Leslie Portney; Janine Hatch*; Kathleen M. Gill-Body Graduate Programs in Physical Therapy, MGH Institute of Health Professions, Boston, MA PURPOSE: The purpose of this study was to examine the relationship between health-related quality of life (HRQOL) and balance ability, balance confidence and physical activity level in elderly individuals. We hypothesized that balance and activity characteristics would be predictive of physical function HRQOL scales. BACKGROUNDS/SIGNIFICANCE: Balance impairments contribute to falls and limited mobility in the elderly. Balance confidence, a self-efficacy measure, has been shown to have a strong correlation with balance ability and physical activity. The influence of balance and physical activity level on HRQOL has not been studied. Establishing this relationship will allow therapists to address a variety of issues in improving balance and quality of life. SUBJECTS: Fifty community-dwelling elders, 46 female and 4 male, 65-95 years old (mean=81.7 yrs) volunteered for the study. Subjects resided in assisted living, senior housing or private residences. Subjects were able to ambulate at least 20 feet without human assistance, had no significant lower extremity impairment or surgery in the past 2 years, or history of neurological disorders. METHODS AND MATERIALS: HRQOL was assessed using the 8 subscales of the SF-36 health status questionnaire. Predictive variables included four balance and fall assessments: balance ability, measured by the Berg Balance Scale (BBS), functional mobility measured by the Timed Up & Go (TUG), balance confidence, measured by the Activities-specific Balance Confidence (ABC) scale, and history of falls over the past 12 months. Subject characteristics included age and presence of co-morbidities. Activity level was assessed as a function of engagement in social and physical activities at least 3 times per week, use of an assistive device for ambulation, and whether the subject lived alone or required the assistance of another person for daily activities. ANALYSES: Data were analyzed using descriptive statistics and a series of stepwise multiple regression analyses with each of the eight SF-36 subscale scores as dependent variables. Independent variables included balance and fall measures, subject characteristics and activity level variables. RESULTS: Descriptive statistics for activity level and subject characteristics are presented in Table 1. The majority of subjects participated in exercise and social activities at least 3 times per week, lived alone, had a history of falls within the last year, and experienced cardiac or vision problems. Descriptive statistics for balance and SF- 36 scores are given in Table 2. Mean BBS and TUG scores were just above the standard cutoff (45 and 14, respectively) for predicting fall risk. Although a cutoff score for the ABC has not been established, a mean of 78.9 (out of 100) suggests that these elders were generally secure in perception of their own balance. All SF-36 subscales were above the generalized population mean of 50, with the highest scores reported for the Mental, Emotional and Social Function scales. The lowest score was reported for the Physical Function scale. Regression analyses showed that the Physical Function subscale was explained by use of assistive devices, ABC score, history of osteoarthritis and participation in social activities (R2=.74). The Role Physical subscale was explained by the ABC, BBS and regular physical exercise (R2=.45). All other subscales had R2 values between .078 and .240. CONCLUSIONS: The scores for balance and HRQOL scales for this sample suggest that our subjects were moderately to highly functional, both physically and mentally. Results demonstrate that physical components of HRQOL (Physical Function and Role Physical subscales) are related to one's level of activity and confidence in the ability to maintain balance during functional activities. By understanding these relationships, physical therapists can design programs that will not only serve to improve impairment-based limitations, but can promote an enhanced quality of life and mimimize the overall burden of disease or disability in elderly individuals. FUNDING SOURCE: This project was partially supported by a grant from the Marjorie K. Ionta Fund through the MGH Institute of Health Professions and Massachusetts General Hospital. KEYWORDS: Balance, geriatric, Health-related quality of life, Balance confidence TABLE 1. Activity Level Variables and Subject Characteristics (N=50) TABLE 2. 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