Katsumata Yuriko, Arai Asuna, Tamashiro Hiko
Department of Environmental and Preventive Medicine, Faculty of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Okinawa 903-0215, Japan.
Arch Gerontol Geriatr. 2007 Jul-Aug;45(1):9-18. doi: 10.1016/j.archger.2006.07.005. Epub 2006 Sep 25.
Using the data from the community-based longitudinal study of the elderly persons aged 65 or older, this study examined relationships between the occurrence of falls varied by their activity level and subsequent functional decline over time. Of the 705 respondents at baseline, 662 and 632 subjects were assessed at first and second follow-ups. Falling and homebound status at baseline and health function (self-rated general health, activities of daily living (ADLs), instrumental activities of daily living (IADLs), intellectual activity, and social role) at baseline and follow-ups were assessed, and changes in each health function were compared among four groups defined by baseline falling/homebound status. Baseline falling/homebound status was significantly associated with subsequent decline in ADLs over 1 year, and in ADLs, IADLs, intellectual activity, and social role over 2 years. Being homebound might act as a stronger risk factor for ADLs disabilities rather than the occurrence of falls. Moreover, the homebound elderly with no experience of falls was at the greatest risk of the decline of social role. We consider that prevention program and home-based care for homebound elderly should be provided in the community.
利用针对65岁及以上老年人的社区纵向研究数据，本研究考察了因活动水平不同而导致的跌倒发生率与随后随时间推移的功能衰退之间的关系。在基线时的705名受访者中，662名和632名受试者分别在第一次和第二次随访时接受了评估。评估了基线时的跌倒和居家状况以及基线和随访时的健康功能（自评总体健康状况、日常生活活动（ADL）、工具性日常生活活动（IADL）、智力活动和社会角色），并比较了由基线跌倒/居家状况定义的四组人群中各项健康功能的变化。基线跌倒/居家状况与随后1年内ADL的下降以及2年内ADL、IADL、智力活动和社会角色的下降显著相关。居家可能是导致ADL残疾的更强风险因素，而非跌倒的发生。此外，从未跌倒过的居家老年人社会角色下降的风险最大。我们认为应在社区中为居家老年人提供预防项目和居家护理。
