Murray Kate J, Hill Keith, Phillips Bev, Waterston John
Public Health Division, National Ageing Research Institute, Parkville, Victoria, Australia.
Disabil Rehabil. 2005 May 6;27(9):499-506. doi: 10.1080/09638280400018486.
To compare falls risk in older fallers and non-fallers, with an emphasis on dizziness and signs of vestibular dysfunction.
The fallers had presented to the Emergency Department of the Royal Melbourne Hospital, Australia following a fall and were discharged directly home (n = 20) (75% female, mean age 78 years). The non-fallers were an age and gender matched group, who had not fallen in the past 12 months (n = 20). All clients received a home-based assessment, which involved a comprehensive assessment of falls risk.
Over three-quarters of the fallers took four or more medications, had balance impairments, and used a gait aid in the community. The fallers had a significantly higher falls risk score (P < 0.001), demonstrated significantly poorer balance (P < 0.001) and walked significantly more slowly (P < 0.001) than the non-fallers. There was no significant difference between the groups in their reports of dizziness (P = 0.68), although static balance testing (CTSIB condition 5) suggested a greater degree of underlying vestibular dysfunction in the group of fallers (P < 0.001).
Older people discharged home from the ED following a fall are at high risk of falling in the future and have a greater level of vestibular dysfunction based on simple clinical testing. Additional clinically applicable tests of vestibular function are required to further investigate the relationship between vestibular dysfunction and falling in older people.
比较老年跌倒者和非跌倒者的跌倒风险，重点关注头晕和前庭功能障碍的体征。
跌倒者在澳大利亚皇家墨尔本医院急诊科因跌倒就诊后直接出院回家（n = 20）（75%为女性，平均年龄78岁）。非跌倒者是年龄和性别匹配的组，在过去12个月内未跌倒（n = 20）。所有患者均接受了基于家庭的评估，其中包括对跌倒风险的全面评估。
超过四分之三的跌倒者服用四种或更多药物，存在平衡障碍，并在社区中使用助行器。与非跌倒者相比，跌倒者的跌倒风险评分显著更高（P < 0.001），平衡能力显著更差（P < 0.001），行走速度显著更慢（P < 0.001）。两组在头晕报告方面无显著差异（P = 0.68），尽管静态平衡测试（CTSIB条件5）表明跌倒者组存在更严重的潜在前庭功能障碍（P < 0.001）。
跌倒后从急诊科出院回家的老年人未来跌倒风险高，基于简单临床测试显示其前庭功能障碍程度更高。需要更多临床适用的前庭功能测试来进一步研究前庭功能障碍与老年人跌倒之间的关系。
