Nitz J C, Choy N L Low
University of Queensland, Physiotherapy, Brisbane, Australia.
Climacteric. 2008;11(6):461-6. doi: 10.1080/13697130802398517.
This study aimed to report falls and identify factors that might predict a fall in women aged between 40 and 80 years and thus provide evidence of earlier falls and need for morbidity preventive intervention.
A prospective cohort study design over 5 years. Personal demographic data of age, co-morbidities, number of prescribed medications, falls, activity level and living situation were obtained at face-to-face interview. Height, weight, body mass index and postural stability were measured in participating women living independently in the community.
Women were categorized into age decade cohorts, with 463 remaining at the year 5 assessment. At baseline, 8% of the women in their forties, 14% in their fifties, 25% in their sixties and 40% in their seventies had fallen in the previous 12 months. Over the 5-year study period, 21% of women in their forties and fifties, 31% of women in their sixties and 47% in their seventies had fallen. Multiple fallers mostly comprised women in their sixties and seventies. Parametric modeling and the classification tree approach revealed age and number of co-morbidities to be most predictive of a fall. Women < 60 years old had an increased risk of a fall by 8% and women > 60 years an increased risk of a fall by 35% with every additional co-morbidity. Stability and other demographics were not predictive of falling.
For women over 40 years old, the number of co-morbidities increased the risk of a fall. The falls risk escalated with additional co-morbidities if they were over 60 years. Preventive program participation to maintain good health beginning by the forties appears vital to prevent falls.
本研究旨在报告40至80岁女性的跌倒情况,并确定可能预测跌倒的因素,从而为早期跌倒及发病预防干预需求提供证据。
一项为期5年的前瞻性队列研究设计。通过面对面访谈获取年龄、共病情况、处方药数量、跌倒情况、活动水平和生活状况等个人人口统计学数据。对独立生活在社区中的参与研究的女性测量身高、体重、体重指数和姿势稳定性。
将女性按年龄十年分组,在第5年评估时有463人留存。基线时,40多岁的女性中有8%、50多岁的女性中有14%、60多岁的女性中有25%、70多岁的女性中有40%在过去12个月中发生过跌倒。在5年研究期间,40多岁和50多岁的女性中有21%、60多岁的女性中有31%、70多岁的女性中有47%发生过跌倒。多次跌倒者大多为60多岁和70多岁的女性。参数建模和分类树方法显示年龄和共病数量最能预测跌倒。每增加一种共病,60岁以下女性跌倒风险增加8%,60岁以上女性跌倒风险增加35%。稳定性和其他人口统计学因素不能预测跌倒。
对于40岁以上女性,共病数量增加跌倒风险。60岁以上女性若有更多共病,跌倒风险会进一步升高。从40多岁开始参与预防计划以保持良好健康状态对于预防跌倒似乎至关重要。