Balance Disorders Linked To Greater Mortality Than Cancer or Heart Disease

MedicalResearch.com Interview with:
Chao Cao, MPH

PhD student in Movement Science,
Program in Physical Therapy, Washington University School of Medicine.
Senior author:
Lin Yang,
Research Scientist/Epidemiologist
Department of Cancer Epidemiology and Prevention Research
Cancer Care Alberta | Alberta Health Services | Canada

MedicalResearch.com: What is the background for this study?

dizziness-vertigoResponse: Dizziness and imbalance are common among US adults and increases the risk of serious injuries. However, research related to balance overwhelmingly focuses on functional outcomes among older adults, therefore our understanding on how balance function may affect the long-term health outcomes in adults of different age group is limited.

MedicalResearch.com: What are the main findings? 

Response: We found that balance disorder affects nearly 2/3 of older Americans (65+ yr) as well as 1/3 of those middle-aged (50-64 yr). Our study, for the first time, found that for middle-aged and older Americans, their overall and sensory-specific balance disorders (visual, proprioceptive, and vestibular) were associated with higher mortality risks driven by cancer and CVD death over 12 years.  

MedicalResearch.com: What should readers take away from your report?

Response: Currently, the screening of balance problems has been recommended in the older population with the goal to prevent falls. However, this practice is absent in middle-aged adults, who are left with elevated risks of adverse health outcomes and mortality associated with balance disorders. More importantly, primary care screening for balance function frequency uses crude measurements (e.g. 1-leg standing test) and does not detect balance disorders due to specific sensory impairments such as the vestibular system. This screening practice fails to refer patients to appropriate specialties and consequently delays their treatment.

Herein, our findings suggested that balance function can be an indicator/marker of long-term health outcomes and mortality risks. The screening of sensory-specific balance function should be implemented in not only older adults but also middle-aged adults and individuals with high risks of balance disorders, such as patients with chronic diseases. The multifactorial assessment and management of balance disorders may need to consider the metabolic system.

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: Further studies are needed to confirm these findings and evaluate whether the observed associations represent a causal biological phenomenon and, if so, whether the effect is modifiable with a multicomponent exercise program.

MedicalResearch.com: Is there anything else you would like to add?

Response: Patients with acute balance disorders/dizziness could be treated in primary care or referred to ENT (ear, nose, and throat) specialist or a doctor who specializes in the brain and nervous system. The balance function may be improved through rehabilitation directed by specialized physical therapists. Currently, long-term deficits in balance function may be without a cure but interventions are available to manage and potentially improve balance function through a multicomponent exercise program and/or holistic exercise (e.g. Tai Chi).  

Conflict of Interest Disclosures: None  


Cao C, Cade WT, Li S, McMillan J, Friedenreich C, Yang L. Association of Balance Function With All-Cause and Cause-Specific Mortality Among US Adults. JAMA Otolaryngol Head Neck Surg. Published online March 11, 2021. doi:10.1001/jamaoto.2021.0057



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Last Updated on March 18, 2021 by Marie Benz MD FAAD