von Heideken Wågert Petra, Gustafson Yngve, Kallin Kristina, Jensen Jane, Lundin-Olsson Lillemor
Department of Community Medicine and Rehabilitation, Geriatric Medicine and Physiotherapy, Umeå University, SE-901 87 Umeå, Sweden.
Arch Gerontol Geriatr. 2009 Nov-Dec;49(3):390-6. doi: 10.1016/j.archger.2008.12.005. Epub 2009 Jan 13.
The aim of this study was to describe incidences of falls and fall-related injuries, and to identify predisposing factors for falls in very old people in a prospective population-based follow-up study for falls. The study is part of the Umeå 85+ Study which includes half of the population aged 85, and the total population aged 90 and > or =95 (-103), in Umeå, Sweden. Of the 253 people interviewed, 220 (87%) were followed up for falls for 6 months, of whom 109 lived in ordinary and 111 in institutional housing. A comprehensive geriatric baseline assessment was made through interviews and testing during home visits. Forty percent of the participants did fall a total 304 times, corresponding to 2.17 falls per Person Year (PY). It occurred 0.83 injuries per PY, including 0.14 fractures per PY. In a Cox regression analysis, the independent explanatory risk factors for time to first fall were dependency in activities of daily living (ADL), thyroid disorders, treatment with selective serotonin reuptake inhibitors (SSRIs) and occurrence of falls in the preceding year. It could be predicted that every seventh participant and every third of the people who did fall would suffer a fracture within 1 year. ADL, thyroid disorders and treatment with SSRIs should be considered in fall prevention programmes.
本研究旨在描述跌倒及与跌倒相关伤害的发生率,并在一项基于人群的前瞻性跌倒随访研究中,确定高龄老人跌倒的诱发因素。该研究是于默奥85岁及以上老人研究的一部分,涵盖了瑞典于默奥市85岁人群的一半,以及90岁及95岁以上(至103岁)的全部人群。在接受访谈的253人中,220人(87%)接受了为期6个月的跌倒随访,其中109人居住在普通住宅,111人居住在机构养老机构。通过家访期间的访谈和测试,进行了全面的老年综合基线评估。40%的参与者共跌倒304次,相当于每人每年(PY)跌倒2.17次。每人每年发生0.83次伤害,其中包括0.14次骨折。在Cox回归分析中,首次跌倒时间的独立解释性风险因素包括日常生活活动(ADL)依赖、甲状腺疾病、使用选择性5-羟色胺再摄取抑制剂(SSRI)治疗以及上一年发生过跌倒。可以预测,每七名参与者中就有一名,以及每三名跌倒者中就有一名会在1年内发生骨折。在预防跌倒计划中应考虑ADL、甲状腺疾病和SSRI治疗。