From Near Falls to Compensated Loss of Balance: A Concept Analysis in Older People

INTRODUCTION: Near falls, defined as recoverable postural instability, are increasingly recognised as important experiences that can provide insight into balance and mobility in older people, yet they are often underreported and inconsistently documented. Unlike falls, which have been clearly defined and extensively investigated, the conceptual definition of near falls remains inconsistent. This concept analysis aimed to clarify the phenomenon traditionally described as 'near falls' and to establish a more precise conceptual definition in older people. METHODS: This is a concept analysis using the framework by Walker and Avant. A comprehensive literature search of four databases was conducted in Medline, PubMed, Scopus and CINAHL. Data extraction and synthesis were guided by the eight-step framework of Walker and Avant. RESULTS: A total of 23 articles were included in the analysis. Antecedents included intrinsic and extrinsic factors. Defining attributes of near falls comprised transient loss of balance, activation of compensatory mechanisms (e.g., rapid stepping, trunk or limb adjustments) and successful prevention of a fall. Consequences involved increased fall risk, changes in physical functions and psychological impacts. CONCLUSIONS: Based on findings, the concept was refined and reconceptualised as 'Compensated Loss of Balance' (CLB), a more precise term emphasising recoverable postural instability through successful corrective responses. IMPLICATIONS FOR PRACTICE: Integrating CLB into clinical screening, research frameworks and fall prevention guidelines may enhance early detection of postural instability and promote more standardised approaches to fall risk assessment and prevention.