Department of Geriatrics, Nagoya University Graduate School of Medicine, 65 Tusruma-cho, Showa-ku, Nagoya 466-8550, Japan.
Arch Gerontol Geriatr. 2010 Jan-Feb;50(1):77-81. doi: 10.1016/j.archger.2009.02.001. Epub 2009 Mar 17.
Numerous risk factors of falls, including urinary incontinence and behavioral symptoms have been identified among elderly people in long-term care settings. However, it remains uncertain whether incontinence or behavioral symptoms are associated with recurrent falls and injurious falls. The purpose of this research was to examine the association between various types of falls and urinary incontinence or behavioral symptoms among the residents of long-term care facilities using the Cox proportional hazards models. The participants were 1082 older people (327 men and 755 women) who were admitted to facilities between 1 April 2003 and 31 March 2004. Fall experience, urinary incontinence, and behavioral symptoms were followed for up to 6 months or until death or discharge. The functional status, comorbidity, and prescribed medications were determined at the baseline. Multivariate analysis revealed that urinary incontinence and behavioral symptoms were independent risk factors of falls during the follow-up period. However, urinary incontinence was a risk factor for recurrent falls but not for injurious falls. In contrast, behavioral symptoms were an independent risk factor for injurious but not for recurrent falls. The results suggested that treatment or management of urinary incontinence and behavioral symptoms should be considered to prevent falls in long-term care settings.
许多与老年人跌倒相关的风险因素,包括尿失禁和行为症状,已在长期护理环境中得到确定。然而,尿失禁或行为症状是否与反复跌倒和受伤性跌倒有关仍然不确定。本研究的目的是使用 Cox 比例风险模型,检验长期护理机构居民中各种类型的跌倒与尿失禁或行为症状之间的关系。参与者为 1082 名老年人(327 名男性和 755 名女性),他们于 2003 年 4 月 1 日至 2004 年 3 月 31 日期间入住机构。跌倒经历、尿失禁和行为症状的随访时间最长为 6 个月,或直至死亡或出院。在基线时确定了功能状态、合并症和规定的药物治疗。多变量分析显示,尿失禁和行为症状是随访期间跌倒的独立危险因素。然而,尿失禁是复发性跌倒的危险因素,但不是受伤性跌倒的危险因素。相反,行为症状是受伤性跌倒的独立危险因素,但不是复发性跌倒的危险因素。研究结果表明,在长期护理环境中,应考虑治疗或管理尿失禁和行为症状,以预防跌倒。