Prevalence of Balance Impairment and Its Association with Quality of Life Among Older Adults

Abstract

Background: Balance impairment is common in aging and is strongly associated with falls, disability, and reduced health-related quality of life (HRQoL). Objective: To determine the prevalence of balance impairment and examine its association with HRQoL among older adults in Sialkot, Pakistan. Methods: A cross-sectional study was conducted from December 2024 to August 2025 across hospitals, outpatient clinics, and old homes in Sialkot. Using convenience sampling, 267 adults aged ≥60 years were recruited. Balance was assessed using the Berg Balance Scale (BBS) and categorized as normal (40–56), mild (21–39), moderate (11–20), or severe impairment (0–10). HRQoL was evaluated using the SF-36 questionnaire. Associations between balance categories and HRQoL categories were tested using chi-square with effect size estimation, and correlation between total BBS and HRQoL scores was assessed using Pearson’s correlation. Results: Participants had a mean age of 67.62 ± 7.46 years; 70.8% were female. Normal balance was observed in 37.5%, while 44.2% had mild, 10.1% moderate, and 8.2% severe impairment (mean BBS = 33.79 ± 13.64). Mean HRQoL score was 93.73 ± 10.15. Balance category showed a borderline association with HRQoL category (χ² = 12.475, df = 6, p = 0.052; Cramér’s V = 0.153), while total BBS correlated positively with HRQoL (r = 0.308, p < 0.001). Conclusion: Balance impairment was highly prevalent and was positively associated with HRQoL, supporting the need for routine balance screening and targeted rehabilitation interventions in older adults.