Gassmann K-G, Rupprecht R, Freiberger E
nterdisciplinary Centre of Gerontology, University of Erlangen-Nuremberg, Germany.
Z Gerontol Geriatr. 2009 Feb;42(1):3-10. doi: 10.1007/s00391-008-0506-2. Epub 2009 Apr 10.
Little is known about the prevalence of falls and the related risk factors in the general population of community-living older people in Germany.
To assess the prevalence and related predictors of different types of falls in a sample of community-dwelling 65 years and older people in Germany living in a metropolitan area. Study design and setting prospective cohort study in 622 community dwelling people aged > or =65 years.
A total of 107 persons (17.2%) reported falling at least once (occasional fallers), while 36 (5.7%) experienced two or more falls (recurrent fallers) in the last 6 months. Main predictors for all fallers were age (OR 1.8; 95% CI 1.1-3.0), being female (OR 1.7; 95% CI 1.1-2.2), living alone (OR 1.9; 95% CI 1.2-2.9), poor health status (OR 3.3; 95% CI 2.1-5.3), varifocals (OR 1.7; 95% CI 1.0-3.1), disturbance of memory (OR 1.7; 95% CI 1.0-3.0), depression (OR 4.8; 95% CI 2.5-9.2), sleep disturbances (OR 2.7; 95% CI 1.7-4.3), incontinence (OR 2.1; 95% CI 1.3-4.9), dizziness (OR 3.0; 95% CI 1.9-5.0), 3 medical conditions or more (OR 3.3; 95% CI 2.1-5.1), lower physical functioning and mobility. Two of the strongest predictors were reported falls (OR 4.9; 95% CI 3.1-7.7) and recurrent falls (OR 10.0; 95% CI 5.0-20.0) in the last 6 months.
Older adults living at home should be screened for falls in history and problems in gait and mobility in any anamnesis to identify those who are at risk for falls.
在德国社区生活的老年人总体人群中，跌倒的患病率及其相关风险因素鲜为人知。
评估德国大都市地区65岁及以上社区居住老年人样本中不同类型跌倒的患病率及其相关预测因素。研究设计与设置：对622名年龄≥65岁的社区居住者进行前瞻性队列研究。
共有107人（17.2%）报告至少跌倒过一次（偶尔跌倒者），而在过去6个月中有36人（5.7%）经历过两次或更多次跌倒（反复跌倒者）。所有跌倒者的主要预测因素包括年龄（比值比1.8；95%置信区间1.1 - 3.0）、女性（比值比1.7；95%置信区间1.1 - 2.2）、独居（比值比1.9；95%置信区间1.2 - 2.9）、健康状况差（比值比3.3；95%置信区间2.1 - 5.3）、双焦点眼镜（比值比1.7；95%置信区间1.0 - 3.1）、记忆障碍（比值比1.7；95%置信区间1.0 - 3.0）、抑郁（比值比4.8；95%置信区间2.5 - 9.2）、睡眠障碍（比值比2.7；95%置信区间1.7 - 4.3）、尿失禁（比值比2.1；95%置信区间1.3 - 4.9）、头晕（比值比3.0；95%置信区间1.9 - 5.0）、患有3种或更多种疾病（比值比3.3；95%置信区间2.1 - 5.1）、身体功能和活动能力较低。两个最强的预测因素是过去6个月内报告的跌倒（比值比4.9；95%置信区间3.1 - 7.7）和反复跌倒（比值比10.0；95%置信区间5.0 - 20.0）。
对于居家老年人，应在病史询问中筛查跌倒情况以及步态和活动能力方面的问题，以识别有跌倒风险的人群。
