Chu Leung-Wing, Chiu Alice Y Y, Chi Iris
FRCP, University Department of Medicine, Queen Mary Hospital, The University of Hong Kong, 102 Pokfulam Road, Hong Kong, Hong Kong SAR.
J Gerontol A Biol Sci Med Sci. 2006 Apr;61(4):399-404. doi: 10.1093/gerona/61.4.399.
The objective of the present study was to investigate the impact of incident falls on the balance, gait, and Activities of Daily Living functioning in community-dwelling older adults.
This was a population-based, 1-year prospective cohort study in older adults. We performed baseline assessment of potential predictors, the 1-year occurrence of falls, and then 1-year reassessment of the following outcome measures: the Barthel Index (BI), Lawton's Instrumental Activities of Daily Living (IADL) scale, gait speed, and Tinetti Balance and Gait Evaluation's total mobility score (TMS). At 1 year of follow-up, participants who had declined by > or = 1 standard deviation (SD) below the baseline mean value of each outcome measure were classified as "decliners."
Of the 1517 participants, 93.5% (n = 1419) completed the 1-year follow-up reassessment of BI and IADL. For gait speed and TMS, respectively, 88.2% (n = 1338) and 88.3% (n = 1339) completed the 1-year outcome assessment. Fallers, particularly recurrent fallers, experienced significantly greater 1-year declines in the four functional measures. Multivariate logistic regression analyses showed that an incident fall was a significant independent predictor for decliners in the BI, Lawton's IADL score, gait speed, and TMS after adjustment of all significant confounding factors. The relative risks of an incident fall as an independent predictor for decliners in the BI, IADL score, gait speed, and TMS were 2.4 (95% confidence interval [CI], 1.4-4.0; p =.01), 2.9 (95% CI, 1.7-5.2; p <.001), 2.4 (95% CI, 1.5-3.8; p <.001), and 4.6 (95% CI, 2.7-7.8; p <.001), respectively.
Incident falls have a significant negative impact on the balance, gait, and Activities of Daily Living functioning in community-dwelling older adults.
本研究的目的是调查社区居住的老年人中，跌倒事件对其平衡能力、步态及日常生活功能的影响。
这是一项针对老年人的基于人群的1年前瞻性队列研究。我们对潜在预测因素进行了基线评估、记录了1年内的跌倒发生情况，然后对以下结局指标进行了1年的重新评估：巴氏指数（BI）、Lawton日常生活能力量表（IADL）、步速以及Tinetti平衡与步态评估的总活动能力得分（TMS）。在随访1年时，各结局指标下降幅度大于或等于基线平均值1个标准差（SD）的参与者被归类为“下降者”。
1517名参与者中，93.5%（n = 1419）完成了BI和IADL的1年随访重新评估。步速和TMS的1年结局评估完成率分别为88.2%（n = 1338）和88.3%（n = 1339）。跌倒者，尤其是反复跌倒者，在这四项功能指标上1年的下降幅度显著更大。多因素逻辑回归分析显示，在调整所有显著混杂因素后，跌倒事件是BI、Lawton IADL评分、步速和TMS下降者的显著独立预测因素。跌倒事件作为BI、IADL评分、步速和TMS下降者独立预测因素的相对风险分别为2.4（95%置信区间[CI]，1.4 - 4.0；p = 0.01）、2.9（95% CI，1.7 - 5.2；p < 0.001）、2.4（95% CI，1.5 - 3.8；p < 0.001）和4.6（95% CI，2.7 - 7.8；p < 0.001）。
跌倒事件对社区居住的老年人的平衡能力、步态及日常生活功能有显著负面影响。
