Chen Yi-Ming, Hwang Shinn-Jang, Chen Liang-Kung, Chen Der-Yuan, Lan Chung-Fu
Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.
J Chin Med Assoc. 2008 Apr;71(4):180-5. doi: 10.1016/S1726-4901(08)70101-1.
Falls are major causes of mortality and morbidity in the elderly. Cognitive dysfunction, poor physical function and medical comorbidities are associated with many factors contributing to falls. The main purpose of this study was to explore the risk factors of falls among older institutionalized Chinese men in Taiwan.
Residents aged over 65 in a veterans care home in northern Taiwan were enrolled for study after they gave their full consent. Falling was defined as a fall within the past 180 days as defined by the Minimum Data Set (MDS). Physical function was determined by MDS resource utilization group activity of daily living score (RUG ADL score). Cognitive status was measured by MDS cognition scale (MDS COGS).
In total, 585 residents (mean age, 80.9 +/- 5.4 years) were enrolled. Among all study subjects, 92.8% were physically independent and 20.2% were moderately cognitive impaired according to MDS COGS. By definition, 48 subjects (8.2%) had a past history of fall. Compared with non-fallers, fallers were significantly older (82.4 +/- 5.5 years vs. 80.7 +/- 5.4 years; p = 0.047) and had poorer functional status according to the MDS RUG ADL score (5.0 +/- 2.3 vs. 4.3 +/- 1.6; p = 0.044). Subjects with past history of anxiety disorder and cardiovascular disease were more prone to fall, and subjects who took hypnotics were also at a higher risk of falling. By using multivariate logistic regression, we found that higher RUG ADL score (odds ratio [OR], 1.18; 95% confidence interval [CI], 1.08-1.37; p = 0.017) and hypnotic use (OR, 2.0; 95% CI, 1.0-4.1; p = 0.048) were both independent risk factors for falls.
The prevalence of fall in the past 180 days was 8.2% among elderly residents in a veterans care home in northern Taiwan. The independent risk factors for falls in this setting included poorer functional status and hypnotic use.
跌倒是老年人死亡和发病的主要原因。认知功能障碍、身体功能不佳和合并症与导致跌倒的许多因素有关。本研究的主要目的是探讨台湾地区老年男性机构化照护者中跌倒的危险因素。
台湾北部一家退伍军人疗养院中65岁以上的居民在完全同意后被纳入研究。跌倒定义为根据最低数据集（MDS）定义的过去180天内发生的跌倒。身体功能通过MDS资源利用组日常生活活动评分（RUG ADL评分）确定。认知状态通过MDS认知量表（MDS COGS）测量。
共纳入585名居民（平均年龄80.9±5.4岁）。根据MDS COGS，在所有研究对象中，92.8%身体独立，20.2%有中度认知障碍。根据定义，48名受试者（8.2%）有跌倒史。与未跌倒者相比，跌倒者年龄显著更大（82.4±5.5岁对80.7±5.4岁；p = 0.047），根据MDS RUG ADL评分，其功能状态更差（5.0±2.3对4.3±1.6；p = 0.044）。有焦虑症和心血管疾病史的受试者更容易跌倒，服用催眠药的受试者跌倒风险也更高。通过多因素逻辑回归分析，我们发现较高的RUG ADL评分（比值比[OR]，1.18；95%置信区间[CI]，1.08 - 1.37；p = 0.017）和使用催眠药（OR，2.0；95%CI，1.0 - 4.1；p = 0.048）都是跌倒的独立危险因素。
台湾北部一家退伍军人疗养院中，老年居民过去180天内跌倒的发生率为8.2%。该环境下跌倒的独立危险因素包括功能状态较差和使用催眠药。
