O-89 The association between balance and falls and quality of life among the elderly with COPD: a case control study in Trinidad and Tobago

Methods: Sixty participants (30 COPD, 30 age-matched healthy controls) aged ≥60 years were recruited. COPD diagnosis was confirmed by post-bronchodilator FEV₁/FVC <70%. Falls risk was evaluated using 12-month fall/trip history, the Six-Minute Walk Test (6MWT), and the Berg Balance Scale (BBS). Quality of life was assessed with the modified Medical Research Council Dyspnoea score (mMRC), Hospital Anxiety and Depression Score (HADS), COPD Assessment Test (CAT), and St Georges Respiratory Questionnaire (SGRQ).

Results: Participants had a mean age of 67.65 ± 6.31 years and BMI 26.06 ± 5.56 kg/m². COPD patients exhibited greater smoking exposure, comorbidities, and substance use. They demonstrated lower mean BBS score (49.4 vs. 54.5; p value <0.05) and reduced mean 6MWT (296.6 m vs. 348.9 m; p value 0.71), with higher frequency of trips (median 3 vs. 0.5; p value <0.05) and combined trips/falls (median 4.5 vs. 1; p value <0.05). Post-exercise SpO₂ was lower in COPD patients (96.1% vs. 98.5%; p value <0.05), while pretest SpO₂ and pulse were similar. Mean HADSDepression score 7.5 vs. 3.0, mean HADS-Anxiety score 7.8 vs. 4.6, mean SGRQ total 48.8 vs. 1.2, and CAT 20.7 vs. 0 (p value <0.05 in all cases). Subgrouanalysis showed that COPD patients with ≥1 fall had markedly worse mean BBS score (40.9 vs. 52.6), walking distance (166.2 m vs. 344.1 m), post-test dyspnoea (5.0 vs. 3.1) and fatigue (4.1 vs. 2.1), higher HADS scores (D 9.8 vs. 6.7; A 10.6 vs. 6.8), and poorer mean quality of life scores.

Conclusion: COPD significantly impairs exercise capacity, balance, and increases trips/falls, compounded by greater dyspnoea, fatigue, and psychological distress. Chronic respiratory disease services for COPD should include balance assessment and ameliorative strategies for fall prevention in this vulnerable population.