Murphy Susan L, Dubin Joel A, Gill Thomas M
Institute of Gerontology, University of Michigan, Institute of Gerontology, Ann Arbor, MI 48109-2007, USA.
J Gerontol A Biol Sci Med Sci. 2003 Oct;58(10):M943-7. doi: 10.1093/gerona/58.10.m943.
Fear of falling is a common and potentially modifiable health problem among older persons. However, relatively little is known about who develops fear of falling or why.
From a representative cohort of community-living persons aged 72 years or older, we evaluated 313 women who had no fear of falling. These participants underwent a comprehensive in-home assessment and were reassessed for fear of falling 1 year later. Fall events were ascertained monthly using a validated fall calendar.
84 (27%) participants developed fear of falling at 1 year and 77 (25%) participants experienced at least one fall event. The predisposing factors for developing fear of falling included age 80 years or older (adjusted relative risk 1.48; 95% confidence intervals 1.04-2.12), visual impairment (1.42; 1.01-2.00), a sedentary lifestyle (1.96; 1.35-2.84), and no available emotional support (2.64; 1.57-4.41). The occurrence of a subsequent fall event was also significantly associated with developing fear of falling (unadjusted relative risk 1.70; 1.18-2.45), although this effect was observed only among participants who had at least one predisposing factor.
Among community-living older women, fear of falling develops due to a combination of predisposing factors and subsequent fall events. Since many of the predisposing factors are related to fall risk, preventive efforts to reduce fear of falling may also decrease the likelihood of falling.
害怕跌倒在老年人中是一个常见且可能可改变的健康问题。然而，对于谁会产生害怕跌倒的心理或原因，我们了解得相对较少。
从一个具有代表性的72岁及以上社区居住人群队列中，我们评估了313名不害怕跌倒的女性。这些参与者接受了全面的居家评估，并在1年后再次评估其是否害怕跌倒。每月使用经过验证的跌倒日历确定跌倒事件。
84名（27%）参与者在1年后产生了害怕跌倒的心理，77名（25%）参与者经历了至少一次跌倒事件。产生害怕跌倒心理的诱发因素包括80岁及以上的年龄（调整后的相对风险1.48；95%置信区间1.04 - 2.12）、视力障碍（1.42；1.01 - 2.00）、久坐的生活方式（1.96；1.35 - 2.84）以及没有可用的情感支持（2.64；1.57 - 4.41）。随后跌倒事件的发生也与产生害怕跌倒的心理显著相关（未调整的相对风险1.70；1.18 - 2.45），尽管这种影响仅在至少有一个诱发因素的参与者中观察到。
在社区居住的老年女性中，害怕跌倒的心理是由多种诱发因素和随后的跌倒事件共同导致的。由于许多诱发因素与跌倒风险相关，减少害怕跌倒心理的预防措施也可能降低跌倒的可能性。
