Skip to main content Accessibility help

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

  • Young-Mi Ko (a1), Won-Beom Park (a2), Jae-Young Lim (a3), Ki Woong Kim (a4) and Nam-Jong Paik (a3)...


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.


Corresponding author

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:


Hide All
Anand, S. and Hanson, K. (1997). Disability-adjusted life years: a critical review. Journal of Health Economics, 16, 685702.
Arber, S. and Cooper, H. (1999). Gender differences in health in later life: the new paradox? Social Science and Medicine, 48, 6176.
Armenakis, A. A. (1988). A review of research on the change typology. Research in Organizational Change and Development, 2, 163194.
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.
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.
Bergner, M. (1989). Quality of life, health status, and clinical research. Medical Care, 27 (Suppl.), S148S156.
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.
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.
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.
Brown, D. (1992). Physical activity, ageing, and psychological well-being: an overview of the research. Canadian Journal of Sports Science, 17, 185193.
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.
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.
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.
Fried, L. and Guralnik, J. (1997). Disability in older adults: evidence regarding significance, etiology, and risk. Journal of the American Geriatrics Society, 45, 92100.
Grembowski, D. et al. (1993). Self-efficacy and health behavior among older adults. Journal of Health and Social Behavior, 34, 89104.
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.
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.
Hatch, J., Gill-Body, K. M. and Portney, L. G. (2003). Determinants of balance confidence in community-dwelling elderly people. Physical Therapy, 83, 10721079.
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.
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.
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.
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.
Kim, D. Y. et al. (2005). Validation of the Korean Version of the Oswestry Disability Index. Spine, 30, E123E127.
Korea National Statistical Office (2007). Statistics on the Aged. Seoul: Korea National Statistical Office.
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.
McAuley, E. and Blissmer, B. (2000). Self-efficacy determinants and consequences of physical activity. Exercise and Sport Science Reviews, 28, 8588.
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.
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.
Montorio, I. and Izal, M. (1996). The Geriatric Depression Scale: a review of its development and utility. International Psychogeriatrics, 8, 103112.
Murtagh, K. and Hubert, H. (2004). Gender differences in physical disability among an elderly cohort. American Journal of Public Health, 94, 14061411.
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.
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.
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.
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.
Rejeski, W. J. and Mihalko, S. (2001). Physical activity and quality of life in older adults. Journal of Gerontology (special issue), 56A, 2335.
Rejeski, W., Brawley, L. and Shumaker, S. (1996). Physical activity and health related quality of life. Exercise and Sports Science Reviews, 24, 71108.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.



Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed