Speechley M, Tinetti M
Department of Epidemiology and Biostatistics, University of Western Ontario, London, Canada.
J Am Geriatr Soc. 1991 Jan;39(1):46-52. doi: 10.1111/j.1532-5415.1991.tb05905.x.
Identification of different types of falls and fallers among elderly persons might aid in the targeting of preventive efforts. In a representative sample of 336 community elderly, subjects were assigned to Frail, Vigorous, or Transition groups based on observed patterns of clustering among demographic, physical, and psychological variables. The frequency and circumstances of falls in these three groups were then ascertained. As expected, the observed incidence of falling in one year of follow-up was highest in the Frail group (52%) and lowest in the Vigorous group (17%). However, 22% (5/23) of falls by vigorous subjects, but only 6% (5/89) of falls by frail subjects, resulted in a serious injury. Compared with frail subjects, vigorous fallers were somewhat more likely to fall during displacing activity (53% vs 31%), with an environmental hazard present (53% vs 29%), and on stairs (27% vs 6%). These findings suggest that fall-related injuries can be a serious health problem for vigorous as well as frail elderly persons. Injury prevention, therefore, should be directed at all elderly persons but tailored to expected differences in fall circumstances.
识别老年人中不同类型的跌倒及跌倒者，可能有助于针对性地开展预防工作。在一个由336名社区老年人组成的代表性样本中，根据人口统计学、身体和心理变量的聚类观察模式，将受试者分为虚弱组、活力组或过渡组。然后确定这三组中跌倒的频率和情况。正如预期的那样，在为期一年的随访中，观察到的跌倒发生率在虚弱组最高（52%），在活力组最低（17%）。然而，活力组受试者的跌倒中有22%（5/23）导致了严重损伤，而虚弱组受试者的跌倒中只有6%（5/89）导致严重损伤。与虚弱组受试者相比，活力组跌倒者在移位活动期间跌倒的可能性略高（53%对31%），跌倒时有环境危险因素的可能性更高（53%对29%），在楼梯上跌倒的可能性也更高（27%对6%）。这些发现表明，与跌倒相关的损伤对于活力充沛和身体虚弱的老年人来说都是严重的健康问题。因此，预防损伤应针对所有老年人，但要根据预期的跌倒情况差异进行调整。
