Ballroom dance and balance ability in older adults: a serial mediation model of fear of falling and physical self-efficacy.

Background: Global population aging has made the physical and mental health of older adults a critical public health concern. Balance ability is essential for independent living and fall prevention, but the psychological mechanisms linking ballroom dance to balance ability remain understudied. This cross-sectional study explored the serial mediating roles of fear of falling and physical self-efficacy in the association between ballroom dance and balance ability among community-dwelling older adults. Methods: A cross-sectional design was adopted, recruiting 318 community-dwelling older adults who regularly participated in ballroom dance from northern China. Validated scales (Physical Activity Rating Scale-3, Berg Balance Scale, Fall Efficacy Scale-International, and Physical Self-Efficacy Scale) were used to collect data. Balance ability was assessed in person by trained research assistants using the Berg Balance Scale. Structural equation modeling and the PROCESS macro were applied to test the serial mediation model. Results: (a) Ballroom dance exercise was positively associated with balance ability in older adults. (b) Fear of falling and physical self-efficacy each played a significant independent mediating role between ballroom dance and balance ability. (c) Fear of falling and physical self-efficacy exerted a significant serial mediating effect, with three valid mediating pathways identified. The individual mediating effect of physical self-efficacy was the strongest among all pathways. Conclusion: Lower fear of falling and higher physical self-efficacy are associated with better balance ability in older adults who participate in ballroom dance. These findings provide preliminary correlational evidence for community-based fall prevention and healthy aging programs, while causal interpretations require longitudinal validation.