Downton J H, Andrews K
University Department of Geriatric Medicine, Hope Hospital, Salford, Manchester, U.K.
Aging (Milano). 1991 Sep;3(3):219-28. doi: 10.1007/BF03324009.
Attempts to determine the underlying causes of falls have come to conflicting conclusions, partly because subject groups studied have not been representative of all elderly people. Two hundred and three randomly selected people of 75 years and over, living at home, were visited and questioned about falls experienced in the previous 12 months, and about factors that might be related to falling. Eighty-six subjects (42.4%) had suffered one or more falls during this time, and of fallers, 49 (59.3%) were injured, 9 of them seriously. Women were slightly more likely to have had falls and were more likely to have suffered injury, but no increase in frequency of falls with age was demonstrated. Only a minority of fallers (43.0%) sought medical attention following their fall. Falls outside the home accounted for 39.5% of falls and these were more likely to be due to simple trips or slips. Analysis of the factors related to falls showed a considerable overlap between fallers and non-fallers. Fallers had significantly greater dependency and cognitive impairment, more physical symptoms, and higher scores for anxiety and depression, but there was no association with postural hypotension, neurological abnormalities, or measurements relating to nutritional state. The factors found to be significant on discriminant analysis were combined to determine a "fall risk score". This type of easily calculated score might be of use to medical and paramedical personnel for assessing the risk of falling among the elderly living at home.
为确定跌倒的潜在原因所做的尝试得出了相互矛盾的结论，部分原因是所研究的受试群体并不代表所有老年人。研究人员走访了随机挑选出的203名75岁及以上的居家老人，询问他们在过去12个月内的跌倒经历以及可能与跌倒有关的因素。在此期间，86名受试者（42.4%）曾跌倒过一次或多次，在跌倒者中，49人（59.3%）受伤，其中9人伤势严重。女性跌倒的可能性略高，受伤的可能性也更大，但未发现跌倒频率随年龄增加。只有少数跌倒者（43.0%）在跌倒后寻求医疗救治。户外跌倒占跌倒总数的39.5%，这些跌倒更可能是由于简单的绊倒或滑倒。对与跌倒相关因素的分析表明，跌倒者和未跌倒者之间存在相当大的重叠。跌倒者的依赖程度和认知障碍明显更高，身体症状更多，焦虑和抑郁得分也更高，但与体位性低血压、神经异常或营养状况测量无关。将判别分析中发现的显著因素结合起来，确定了一个“跌倒风险评分”。这种易于计算的评分可能有助于医护人员评估居家老年人的跌倒风险。
