Kulmala Jenni, Viljanen Anne, Sipilä Sarianna, Pajala Satu, Pärssinen Olavi, Kauppinen Markku, Koskenvuo Markku, Kaprio Jaakko, Rantanen Taina
Department of Health Sciences, The Finnish Centre for Interdisciplinary Gerontology, University of Jyväskylä, Finland.
Age Ageing. 2009 Mar;38(2):162-7. doi: 10.1093/ageing/afn228. Epub 2008 Nov 13.
we studied visual acuity (VA) and co-existing hearing impairment and poor standing balance as predictors of falls.
prospective study with 1-year follow-up.
research laboratory and residential environment.
428 women aged 63-76 years from the Finnish Twin Study on Aging.
participants were followed up for incidence of falls over 1 year. VA, hearing ability and standing balance were assessed at the baseline. The incidence rate ratios (IRR) for falls were computed using the negative binomial regression model.
during the follow-up, 47% of participants experienced a fall. After adjusting for age and interdependence of twin sisters, participants with vision impairment (VA of <1.0) but no other sensory impairments had a higher, but non-significant, risk for falls compared to persons with normal vision (IRR 1.5, 95% CI 0.6-4.2). Co-existing vision impairment and impaired balance increased the risk (IRR 2.7, 95% CI 0.9-8.0), as also did co-existing vision and hearing impairment (IRR 4.2, 95% CI 1.5-11.3), compared to those with normal vision. Among persons with all three impairments, the IRR for falls increased to 29.4 (95% CI 5.8-148.3) compared to participants with good vision.
the impact of vision impairment on fall risk was higher when accompanied with other sensory and balance impairments, probably because the presence of other impairments prevented the reception of compensatory information about body posture and environment being received from other sensory sources. When aiming to prevent falls and their consequences in older people, it is important to check whether poor vision is accompanied with other impairments.
我们研究了视力（VA）、并存的听力障碍和站立平衡能力差作为跌倒预测因素的情况。
为期1年随访的前瞻性研究。
研究实验室和居住环境。
来自芬兰老年双胞胎研究的428名年龄在63 - 76岁之间的女性。
对参与者进行为期1年的跌倒发生率随访。在基线时评估视力、听力和站立平衡能力。使用负二项回归模型计算跌倒的发病率比（IRR）。
在随访期间，47%的参与者发生过跌倒。在调整年龄和双胞胎姐妹的相互依存关系后，与视力正常者相比，视力受损（VA<1.0）但无其他感觉障碍的参与者跌倒风险较高，但无统计学意义（IRR 1.5，95%CI 0.6 - 4.2）。与视力正常者相比，并存视力障碍和平衡能力受损会增加跌倒风险（IRR 2.7，95%CI 0.9 - 8.0），并存视力和听力障碍时也是如此（IRR 4.2，95%CI 1.5 - 11.3）。在所有三种障碍都有的人群中，与视力良好的参与者相比，跌倒的IRR增加到29.4（95%CI 5.8 - 148.3）。
当视力障碍伴有其他感觉和平衡障碍时，其对跌倒风险的影响更大，可能是因为其他障碍的存在阻碍了从其他感觉来源接收有关身体姿势和环境的补偿信息。在旨在预防老年人跌倒及其后果时，检查视力不佳是否伴有其他障碍很重要。
