ORIGINAL ARTICLE Balance performance in older adults and its relationship with falling Mir Mohammad Jalali • Hooshang Gerami • Abtin Heidarzadeh • Robabeh Soleimani Received: 8 April 2014 / Accepted: 1 October 2014 Ó Springer International Publishing Switzerland 2014 Abstract Background and aims A normal consequence of aging is a general deterioration in a number of musculoskeletal and sensory systems that affect postural control and balance. The aim of this study was to evaluate history of falls among active older individuals in Iran, and estimate the risk fac- tors for falls among this population. Methods A total of 448 active older subjects from rural region of Rasht city, Iran, were included. They were divided into three groups depending on their age: young- old (n = 266); middle-old (n = 154) and oldest-old (n = 28). We assessed balance performance by One-Leg Balance (OLB), Functional Reach (FR), Timed Up and Go (TUG) and Romberg tests. Results The fall rate ( [ 2 in the last year) was 27.0 %. The cut-off point 13.75 s for TUG test showed 84.7 % sensitivity and 56 % specificity. Also the best cut-off point for OLB test was 12.7 s (63 % sensitivity and 83.5 % specificity). Logistic regression analysis revealed that age, BMI, diabetes, and failure in OLB, FR, and Romberg tests predicted fall risk. The decision tree classification of older individuals showed three categorical variables, which in their order of importance included diabetes, Romberg test, and OLB test. Conclusions This study revealed the value of history taking about diabetes as a predictor for existing falling. Decision tree technique showed that Romberg and OLB tests help in identifying older adults with balance problems. Given the incidence and consequences of falls among older adults, large-scale prospective studies on older individuals to identify those prone to falls are warranted. Keywords Postural balance Á Accidental falls Á Aged Á Decision tree Introduction With a general increase in life expectancy, the population of older adults is increasing throughout the developed world [1], with newly industrialized countries of Asia showing more rapid aging compared with other countries. The annual rate of increase of the older population (65 years or more) in these countries is reported to be approximately 3 %, compared with 1.0–1.3 % in the Uni- ted Kingdom, Sweden, and the United States [2]. Individ- uals aged 65 years or more accounted for 6 % of the total population of the Islamic Republic of Iran in 2005, while estimates for 2030 placed the proportion of this age group at 19 % [3]. Injurious fall events requiring acute medical attention were estimated at 143.1, 336.7, and 848.3 per 100,000 person-years among males, and 190.2, 416.8, and 854.7 per 100,000 person-years among females of the age groups 60–69, 70–79, and 80?, respectively, in Iran in 2003 [4]. The biological aging process includes certain changes in the musculoskeletal and neuromuscular systems, which M. M. Jalali (&) Á H. Gerami Department of Otolaryngology, Otolaryngology Research Center, Amiralmomenin Hospital, Guilan University of Medical Sciences, 41396-38459 Rasht, Iran e-mail: mmjalali@gmail.com A. Heidarzadeh Department of Community Medicine, Medical Faculty, Guilan University of Medical Sciences, Rasht, Iran R. Soleimani Department of Psychiatry, Medical Faculty, Guilan University of Medical Sciences, Rasht, Iran 123 Aging Clin Exp Res DOI 10.1007/s40520-014-0273-4