功能受限和身体机能不佳作为老年人自我报告骨折的独立危险因素。
Functional limitations and poor physical performance as independent risk factors for self-reported fractures in older persons.
作者信息
Stel V S, Pluijm S M F, Deeg D J H, Smit J H, Bouter L M, Lips P
机构信息
Institute for Research in Extramural Medicine (EMGO Institute), VU University Medical Center, Amsterdam, The Netherlands.
出版信息
Osteoporos Int. 2004 Sep;15(9):742-50. doi: 10.1007/s00198-004-1604-7. Epub 2004 Mar 11.
OBJECTIVE
This study examined whether three aspects of functioning (i.e., functional limitations, physical performance, and physical activity) were associated with fractures in older men and women.
DESIGN
A 3-year prospective cohort study.
PARTICIPANTS AND SETTING
A total of 715 men and 762 women, aged 65 years and older, of the population-based Longitudinal Aging Study Amsterdam.
MEASUREMENTS
During an interview at home, three aspects of functioning were assessed: functional limitations (what people say they can do), physical performance, i.e., three performance tests and handgrip strength (what people are able to do), and physical activity (what people actually do). Afterward, a follow-up on fractures was conducted for 3 years.
RESULTS
77 patients (5.2%) suffered a fracture during 3-year follow-up. Most patients suffered a hip fracture (1.6%) or a wrist fracture (1.4%). The fracture rate per 1,000 person-years was 20.1. During 3-year follow-up, a fracture was reported by 12%, 10%, 12%, and 6% of the respondents with functional limitations, low performance test score, poor handgrip strength, and low physical activity, respectively. Using Cox proportional hazard analysis, functional limitations (RR = 3.5; 95% CI, 2.1 to 6.0), low performance test score (RR = 1.9; 95% CI, 1.1 to 3.3), low handgrip strength (RR = 2.5; 95% CI, 1.5 to 4.1), and low physical activity (RR = 1.9; 95% CI, 1.1 to 3.5) were significantly associated with fractures after adjustment for age and sex. Functional limitations (RR = 3.2; 95% CI, 1.8 to 5.5), low performance test score (RR = 1.8; 95% CI, 1.0 to 3.3) and low handgrip strength (RR = 2.0; 95% CI, 1.1 to 3.6) remained significantly associated with fractures after additional adjustment for body composition, chronic diseases, psychosocial factors, life style factors, and the other levels of functioning. No significant interaction terms were found.
CONCLUSIONS
Functional limitations and poor physical performance were independent risk factors for fractures.
目的
本研究调查了功能的三个方面（即功能受限、身体机能和身体活动）是否与老年男性和女性的骨折有关。
设计
一项为期3年的前瞻性队列研究。
参与者及研究背景
基于阿姆斯特丹纵向老龄化研究的715名男性和762名女性，年龄均在65岁及以上。
测量方法
在家访期间，评估功能的三个方面：功能受限（人们自述能做的事情）、身体机能，即三项机能测试和握力（人们能够做到的事情）以及身体活动（人们实际做的事情）。之后，对骨折情况进行了3年的随访。
结果
77名患者（5.2%）在3年随访期间发生了骨折。大多数患者发生了髋部骨折（1.6%）或腕部骨折（1.4%）。每1000人年的骨折发生率为20.1。在3年随访期间，功能受限、机能测试得分低、握力差和身体活动少的受访者中分别有12%、10%、12%和6%报告发生了骨折。使用Cox比例风险分析，在对年龄和性别进行调整后，功能受限（风险比=3.5；95%置信区间，2.1至6.0）、机能测试得分低（风险比=1.9；95%置信区间，1.1至3.3）、握力低（风险比=2.5；95%置信区间，1.5至4.1）和身体活动少（风险比=1.9；95%置信区间，1.1至3.5）与骨折显著相关。在对身体成分、慢性病、心理社会因素、生活方式因素和其他功能水平进行进一步调整后，功能受限（风险比=3.2；95%置信区间，1.8至5.5）、机能测试得分低（风险比=1.8；95%置信区间，1.0至3.3）和握力低（风险比=2.0；95%置信区间，1.1至3.6）仍与骨折显著相关。未发现显著的交互作用项。
结论
功能受限和身体机能差是骨折的独立危险因素。
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