Shahar Danit, Levi Meital, Kurtz Ilan, Shany Shraga, Zvili Irene, Mualleme Ezra, Shahar Avner, Sarid Orly, Melzer Itzik
S. Daniel Abraham International Center for Health and Nutrition and Department of Epidemiology and Health Services Evaluation, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Ann Nutr Metab. 2009;54(1):59-66. doi: 10.1159/000207356. Epub 2009 Mar 6.
BACKGROUND/AIM: In elderly persons, fall-related injury is a serious public health problem. We investigated the impact of essential nutritional elements on falls in the elderly.
Clinical function, balance, gait and disability tests and health and nutritional status assessments were performed. All subjects were interviewed regarding the occurrence of falls in the last year. Blood tests for serum vitamin D, folate and B(12) were conducted among a randomly selected subsample of 54 participants in the same month.
One hundred 65- to 91-year-old volunteers participated in the study, and 29 of them fell at least once during the past year. The depression score was higher (indicating more depressive symptoms) among fallers compared with non-fallers (4.0 +/- 3.2 vs. 2.5 +/- 2.3, respectively). The overall function score (indicating better function) was marginally higher in non-fallers. Subsequent comparisons between fallers and non-fallers were adjusted for overall function and depression scores. Serum folate was significantly lower in fallers (9.5 +/- 7.1 vs. 16.2 +/- 6.7 ng/ml, p = 0.02). Dietary intake was equal in both groups. Correlation analyses indicate a significant association between vitamin D and the functional measurements: timed get up and go (negative), Berg balance test, overall functional score, lower extremity score and limitation score (positive correlation coefficients). Serum folate was highly and negatively associated with the number of falls and with prescribed medications and was the only protective factor against falls in a multivariate analysis.
Vitamin D was related to most functional and balance measurements. Serum folate was protective against falls. For every 1 ng/ml increase in serum folate the occurrence of falls decreased by 19%.
背景/目的：在老年人中，与跌倒相关的损伤是一个严重的公共卫生问题。我们调查了必需营养元素对老年人跌倒的影响。
进行了临床功能、平衡、步态和残疾测试以及健康和营养状况评估。就所有受试者在过去一年中跌倒的发生情况进行了访谈。在同一月对54名参与者的随机选择子样本进行了血清维生素D、叶酸和维生素B12的血液检测。
100名65至91岁的志愿者参与了该研究，其中29人在过去一年中至少跌倒过一次。跌倒者的抑郁评分更高（表明抑郁症状更多），与未跌倒者相比（分别为4.0±3.2和2.5±2.3）。未跌倒者的总体功能评分（表明功能更好）略高。随后对跌倒者和未跌倒者进行比较时，对总体功能和抑郁评分进行了调整。跌倒者的血清叶酸显著更低（9.5±7.1 vs. 16.2±6.7 ng/ml，p = 0.02）。两组的饮食摄入量相等。相关性分析表明维生素D与功能测量之间存在显著关联：定时起立行走测试（负相关）、伯格平衡测试、总体功能评分、下肢评分和受限评分（正相关系数）。血清叶酸与跌倒次数和处方药高度负相关，并且是多变量分析中唯一预防跌倒的保护因素。
维生素D与大多数功能和平衡测量相关。血清叶酸可预防跌倒。血清叶酸每增加1 ng/ml，跌倒发生率降低19%。
