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跌倒仅仅只是跌倒吗:健康老年人跌倒的相关因素。健康、衰老和身体成分研究。

Is a fall just a fall: correlates of falling in healthy older persons. The Health, Aging and Body Composition Study.

作者信息

de Rekeneire Nathalie, Visser Marjolein, Peila Rita, Nevitt Michael C, Cauley Jane A, Tylavsky Frances A, Simonsick Eleanor M, Harris Tamara B

机构信息

Laboratory of Epidemiology, Demography and Biometry and Gerontology Research Center, National Institute on Aging, Bethesda, Maryland 20892, USA.

出版信息

J Am Geriatr Soc. 2003 Jun;51(6):841-6. doi: 10.1046/j.1365-2389.2003.51267.x.

Abstract

OBJECTIVES

To identify factors associated with falling in well-functioning older people.

DESIGN

Cross-sectional analyses of report of falls over the past 12 months using baseline data from the Health, Aging and Body Composition Study.

SETTING

Clinic examinations in Pittsburgh, Pennsylvania, or Memphis, Tennessee.

PARTICIPANTS

Three thousand seventy-five high-functioning black and white elderly aged 70 to 79 living in the community.

MEASUREMENTS

Physical function assessed using self-report and performance measures. Health status indicators included diseases, medication use, and body composition measures.

RESULTS

Almost one-quarter (24.1%) of women and 18.3% of men reported at least one fall within the year before the baseline examination. Fallers were more likely to be female; white; report more chronic diseases and medications; and have lower leg strength, poorer balance, slower 400-meter walk time, and lower muscle mass. In men, multivariate logistic regression models showed white race (adjusted odds ratio (OR) = 1.4, 95% confidence interval (CI) = 1.2-1.6), slower 6-meter walk speed (OR = 1.1, 95% CI = 1.0-1.3), poor standing balance (OR = 1.2, 95% CI = 1.0-1.4), inability to do 5 chair stands (OR = 1.7, 95% CI = 1.3-1.9), report of urinary incontinence (UI) (OR = 1.5, 95% CI = 1.1-2.0), and mid-quintile of leg muscle strength (OR = 0.6, 95% CI = 0.4-0.9) to be independently associated with report of falling. In women, benzodiazepine use (OR = 1.6, 95% CI = 1.0-2.6), UI (OR = 1.5, 95% CI = 1.2-1.9), and reported difficulty in rising from a chair (OR = 1.4, 95% CI = 1.2-1.6) were associated with past falls.

CONCLUSION

Falls history needs to be screened in healthier older adults. Even for well-functioning older persons, specific correlates of falling can be identified to define those at risk.

摘要

目的

确定功能良好的老年人跌倒的相关因素。

设计

利用健康、衰老和身体成分研究的基线数据,对过去12个月的跌倒报告进行横断面分析。

地点

宾夕法尼亚州匹兹堡或田纳西州孟菲斯的诊所检查。

参与者

3075名居住在社区的70至79岁功能良好的黑人和白人老年人。

测量

使用自我报告和表现测量来评估身体功能。健康状况指标包括疾病、药物使用和身体成分测量。

结果

在基线检查前一年,近四分之一(24.1%)的女性和18.3%的男性报告至少跌倒过一次。跌倒者更可能为女性、白人;报告有更多慢性疾病和正在使用更多药物;小腿力量较弱、平衡能力较差、400米步行时间较长以及肌肉量较低。在男性中,多变量逻辑回归模型显示白人种族(调整后的优势比(OR)=1.4,95%置信区间(CI)=1.2 - 1.6)、6米步行速度较慢(OR = 1.1,95% CI = 1.0 - 1.3)、站立平衡差(OR = 1.2,95% CI = 1.0 - 1.4)、无法完成5次从椅子上站起的动作(OR = 1.7,95% CI = 1.3 - 1.9)、报告有尿失禁(UI)(OR = 1.5,95% CI = 1.1 - 2.0)以及小腿肌肉力量处于五分位数中位数(OR = 0.6,95% CI = 0.4 - 0.9)与跌倒报告独立相关。在女性中,使用苯二氮䓬类药物(OR = 1.6,95% CI = 1.0 - 2.6)、尿失禁(OR = 1.5,95% CI = 1.2 - 1.9)以及报告从椅子上起身困难(OR = 1.4,95% CI = 1.2 - 1.6)与过去的跌倒有关。

结论

需要对健康状况较好的老年人进行跌倒史筛查。即使对于功能良好的老年人,也可以确定跌倒的特定相关因素,以界定那些有风险的人。

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