Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-13T02:15:10.996Z Has data issue: false hasContentIssue false

Discrepancies between balance confidence and physical performance among community-dwelling Korean elders: a population-based study

Published online by Cambridge University Press:  01 August 2009

Young-Mi Ko
Affiliation:
School of Public Health, Seoul National University, Republic of Korea
Won-Beom Park
Affiliation:
Department of Rehabilitation Medicine, Dankook University Hospital, Republic of Korea
Jae-Young Lim*
Affiliation:
Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Republic of Korea
Ki Woong Kim
Affiliation:
Department of Neuropsychiatry, Seoul National University Bundang Hospital, Department of Psychiatry, Seoul National University College of Medicine, Republic of Korea
Nam-Jong Paik
Affiliation:
Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Republic of Korea
*
Correspondence should be addressed to: Jae-Young Lim, Department of Rehabilitation, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 300, Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea, zip code: 463–707. Phone: +82 31 787 7732; Fax: +82 31 787 4056. Email: drlim1@snu.ac.kr.

Abstract

Background: This study investigates discrepancies between the confidence expressed by Korean elders in their balance and their actual physical performances according to sex and age. It also attempts to identify the factors responsible for such gaps or discrepancies.

Methods: The Korean Longitudinal Study on Health and Aging (KLoSHA) was designed as a population-based prospective cohort study on the health and aging of Korean adults aged 65 years and over. We evaluated 1000 of 1118 randomly selected subjects in terms of activities-specific balance confidence (ABC) and performance in regard to balance and gait (POMA). Activities of daily living (ADL) and instrumental activities of daily living (IADL) were assessed to measure disability. Pain-related dysfunctions, depression and cognitive functions were assessed. Next, we assessed the relationship between balance confidence and physical performance and functioning by sex and age.

Results: The balance confidence of elderly women was lower than that of elderly men, although the physical performances of men and women under the age of 80 were similar. Women showed increased functional disability related to lower extremity pain and closely associated with balance confidence. However, psychological variables such as depression and cognitive functioning did not affect balance confidence.

Conclusion: We found a discrepancy between balance confidence and physical performance according to sex and age among Koreans elders. Low balance confidence among women elders was correlated with pain-related dysfunctions other than those reflected in POMA scores. Therefore, enhancing confidence and controlling pain as a means of preventing disability should be emphasized when developing models for maintaining and promoting health in elders.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Anand, S. and Hanson, K. (1997). Disability-adjusted life years: a critical review. Journal of Health Economics, 16, 685702.Google Scholar
Arber, S. and Cooper, H. (1999). Gender differences in health in later life: the new paradox? Social Science and Medicine, 48, 6176.Google Scholar
Armenakis, A. A. (1988). A review of research on the change typology. Research in Organizational Change and Development, 2, 163194.Google Scholar
Bae, J. N. and Cho, M. J. (2004). Development of the Korean version of the Geriatric Depression Scale and its short form among elderly psychiatric patients. Journal of Psychosomatic Research, 297–305.CrossRefGoogle Scholar
Bae, S. C., Lee, H. S., Yun, H. R., Kim, T. H., Yoo, D.-H. and Kim, S. Y. (2001). Cross-cultural adaptation and validation of Korean Western Ontario and McMaster Universities (WOMAC) and Lequesne Osteoarthritis Indices for Clinical Research. Osteoarthritis and Cartilage, 9, 746750.CrossRefGoogle ScholarPubMed
Bergner, M. (1989). Quality of life, health status, and clinical research. Medical Care, 27 (Suppl.), S148S156.CrossRefGoogle ScholarPubMed
Bowling, A. (2007). Gender-specific and gender-sensitive associations with psychological health and morbidity in older age. Baseline findings from a British population survey of ageing. Aging and Mental Health, 11, 301309.CrossRefGoogle ScholarPubMed
Brach, J. S., van Swearingen, J. M., Newman, A. B. and Kriska, A. M. (2002). Identifying early decline of physical function in community-dwelling older women: performance-based and self-reported measures. Physical Therapy, 82, 320328.Google Scholar
Brouwer, B., Musselman, K. and Culham, E. (2004). Physical function and health status among seniors with and without a fear of falling. Gerontology, 50, 135141.CrossRefGoogle ScholarPubMed
Brown, D. (1992). Physical activity, ageing, and psychological well-being: an overview of the research. Canadian Journal of Sports Science, 17, 185193.Google Scholar
Chun, H., Doyal, L., Payne, S., Cho, S. I. and Kim, I. H. (2006). Understanding women, health, and social change: the case of South Korea. International Journal of Health Services, 36, 575592.CrossRefGoogle ScholarPubMed
Daltroy, L. H., Larson, M. G., Eaton, H. M., Phillips, C. B. and Liang, M. H. (1999). Discrepancies between self-reported and observed physical function in the elderly: the influence of response shift and other factors. Social Science and Medicine, 48, 15491561.CrossRefGoogle ScholarPubMed
Filiatrault, J. et al. (2007). Evidence of the psychometric qualities of a simplified version of the Activities-specific Balance Confidence Scale for community-dwelling seniors. Archives of Physical Medicine and Rehabilitation, 88, 664672.Google Scholar
Fried, L. and Guralnik, J. (1997). Disability in older adults: evidence regarding significance, etiology, and risk. Journal of the American Geriatrics Society, 45, 92100.CrossRefGoogle ScholarPubMed
Grembowski, D. et al. (1993). Self-efficacy and health behavior among older adults. Journal of Health and Social Behavior, 34, 89104.CrossRefGoogle ScholarPubMed
Guallar-Castillón, P., Sendino, A. R., Banegas, J. R., López-García, E. and Rodríguez-Artalejo, F. (2005). Differences in quality of life between women and men in the older population of Spain. Social Science and Medicine, 60, 12291240.CrossRefGoogle ScholarPubMed
Hasegawa, K. (1983). The clinical assessment of dementia in the aged: a dementia screening scale for psychogeriatric patients. In Bergener, M. et al. (eds.), Aging in the Eighties and Beyond (pp. 207218). New York: Springer.Google Scholar
Hatch, J., Gill-Body, K. M. and Portney, L. G. (2003). Determinants of balance confidence in community-dwelling elderly people. Physical Therapy, 83, 10721079.Google Scholar
Hudak, P. L., Amadio, P. C. and Bombardier, C. (1996). Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder, and hand) [corrected]. The Upper Extremity Collaborative Group (UECG) American Journal of Industrial Medicine, 29, 602608.Google Scholar
Jang, S. N., Cho, S. I., Ou, S., Lee, E. and Baik, H. (2003). The validity and reliability of Korean Fall Efficacy Scale (FES) and Activities-specific Balance Confidence Scale (ABC). Journal of the Korean Geriatrics Society, 7, 255268.Google Scholar
Jeon, G. S., Jang, S. N., Rhee, S. J., Kawachi, I. and Cho, S. I. (2007). Gender differences in correlates of mental health among elderly Koreans. Journal of Gerontology Series B Psychological Sciences and Social Sciences, 62, S323329.CrossRefGoogle ScholarPubMed
Keysor, J. (2003). Does late-life physical activity or exercise prevent or minimize disablement? A critical review of the scientific evidence. American Journal of Preventive Medicine, 25, 129136.CrossRefGoogle ScholarPubMed
Kim, D. Y. et al. (2005). Validation of the Korean Version of the Oswestry Disability Index. Spine, 30, E123E127.Google Scholar
Korea National Statistical Office (2007). Statistics on the Aged. Seoul: Korea National Statistical Office.Google Scholar
Lee, J.-Y., Lim, J.-Y., Oh, J. H. and Ko, Y.-M. (2008). Cross-cultural adaptation and clinical evaluation of a Korean version of the disabilities of arm, shoulder, and hand outcome questionnaire (K-DASH). Journal of Shoulder and Elbow Surgery, 17, 570574.Google Scholar
McAuley, E. and Blissmer, B. (2000). Self-efficacy determinants and consequences of physical activity. Exercise and Sport Science Reviews, 28, 8588.Google ScholarPubMed
McAuley, E., Konopack, J. F., Morris, K. S., Motl, R. W., Hu, L. and Doerksen, S. E. (2006a). Physical activity and functional limitations in older women: influence of self-efficacy. Journal of Geronotology: Psychological Sciences, 61B, 270277.CrossRefGoogle Scholar
McAuley, E., Konopack, J. F., Motl, R. W., Morris, K. S., Doerksen, S. E. and Rosengren, K. R. (2006b). Physical activity and quality of life in older adults:influence of health status and self-efficacy. Annals of Behavioral Medicine, 31, 99103.CrossRefGoogle ScholarPubMed
Montorio, I. and Izal, M. (1996). The Geriatric Depression Scale: a review of its development and utility. International Psychogeriatrics, 8, 103112.Google Scholar
Murtagh, K. and Hubert, H. (2004). Gender differences in physical disability among an elderly cohort. American Journal of Public Health, 94, 14061411.CrossRefGoogle ScholarPubMed
Myers, A. M., Powell, L. E., Maki, B. E., Holliday, P. J., Brawley, L. R. and Sherk, W. (1996). Psychological indicators of balance confidence: relationship to actual and perceived abilities. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 51A, M37M43.CrossRefGoogle Scholar
Myers, A. M., Fletcher, P. C., Myers, A. H. and Sherk, W. (1998). Discriminative and evaluative properties of the Activities-specific Balance Confidence (ABC) Scale. The Journals of Gerontology. Series A, Biological sciences and medical sciences, 53A, M287M294.Google Scholar
Park, J. H., Soo, L., Jae-Young, L., Kwang-Il, K. and Moon-Ku, H. (2007). An overview of the Korean Longitudinal Study on Health and Aging. Psychiatry Investigator, 4, 8495.Google Scholar
Powell, L. E. and Myers, A. M. (1995). The Activities-specific Balance Confidence (ABC) Scale. The Journals of Gerontology. Series A, Biological sciences and medical sciences, 50A, M2834.Google Scholar
Rejeski, W. J. and Mihalko, S. (2001). Physical activity and quality of life in older adults. Journal of Gerontology (special issue), 56A, 2335.Google Scholar
Rejeski, W., Brawley, L. and Shumaker, S. (1996). Physical activity and health related quality of life. Exercise and Sports Science Reviews, 24, 71108.CrossRefGoogle ScholarPubMed
Rejeski, W. J. et al. (2008). Physical activity in prefrail older adults:confidence and satisfaction related to physical function. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 63B, 1926.CrossRefGoogle Scholar
Salbach, N. M., Mayo, N. E., Robichaud-Ekstrand, S., Hanley, J. A., Richards, C. L. and Wood-Dauphinee, S. (2006). Balance Self-Efficacy and its relevance to physical function and perceived health status after stroke. Archives of Physical Medicine and Rehabilitation, 87, 364370.CrossRefGoogle ScholarPubMed
Scholz, U., Dona, B. G., Sud, S. and Schwarzer, R. (2002). Is general self-efficacy a universal construct? European Journal of Psychological Assessment, 18, 242251.CrossRefGoogle Scholar
Seeman, T. E., Unger, J. B., McAvay, G. and Mendes de Leon, C. F. M. (1999). Self efficacy beliefs and perceived declines in functional ability: MacArthur Studies of successful aging. Journals of Gerontology: Psychological Sciences, 54B, 214222.CrossRefGoogle Scholar
Stewart, A. and King, A. (1991). Evaluating the efficacy of physical activity for influencing quality-of-life outcome in older adults. Annals of Behavioral Medicine, 13, 108116.Google Scholar
Takeda, Y. et al. (2004). Multigenerational family structure in Japanese society: impacts on stress and health behaviors among women and men. Social Science and Medicine, 59, 6981.CrossRefGoogle ScholarPubMed
Tinetti, M. E., Leon, C. F. M. d., Doucette, J. T. and Baker, D. I. (1994). Fear of falling and fall-related efficacy in relationship to functioning among community-living elders. The Journals of Gerontology. Series A, Biological sciences and medical sciences, 49, M140M147.Google Scholar
Vellas, B., Wayne, S., Romero, L., Baumgartner, R. and Garry, P. (1997). Fear of falling and restriction of mobility in elderly fallers. Age and Ageing, 26, 189193.CrossRefGoogle ScholarPubMed
Vellas, B., Wayne, S., Garry, P. and Baumgartner, R. (1998). A two-year longitudinal study of falls in 482 community-dwelling elderly adults. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 53A, M264M274.Google Scholar
Won, C. W., Rho, Y. G., Sunwoo, D. and Lee, Y. S. (2002a). The validity and reliability of Korean Instrumental Activities of Daily Living (K-IADL) Scale. Journal of the Korean Geriatric Society, 6, 273280.Google Scholar
Won, C. W., Rho, Y. G., Kim, S. Y., Cho, B. R. and Lee, Y. S. (2002b). The validity and reliability of Korean Activities of Daily Living (K-ADL) Scale. Journal of the Korean Geriatric Society, 6, 98106.Google Scholar
Yang, D. W. et al. (2004). Reliability and validity of the Korean version of the revised form of Hasegawa Dementia Scale (K-HDS). Journal of the Korean Neurological Association, 22, 315321.Google Scholar