Department of Health Promotion, TNO Quality of Life, Leiden, The Netherlands.
Prev Med. 2010 Mar;50(3):143-7. doi: 10.1016/j.ypmed.2009.12.014. Epub 2010 Jan 4.
Common expressions of falls risk do not include exposure to hazards. We compared two expressions: the commonly used population incidence (fallers per 1000 person-years) and the FARE (FAlls Risk by Exposure): the number of fallers per 1000 physically active person-days.
Prospective follow-up study among community dwelling older persons (N=771) aged between 71 and 96 years in The Netherlands, 2005. Baseline data on age, gender, disabilities (vision, mobility), and number of days per week with minimally 30 min of physical activity were collected. Falls were registered monthly. Falls risk was expressed as the number of falls per 1000 person-years and as the FARE. A balance control difficulty score was based on the sumscore of 11 disability items.
Increased difficulty controlling balance was linearly associated with reduced exposure to risky situations (Spearman correlation coefficient=-.56) and to an increased falls risk per 1000 person-years. In contrast, the FARE score increased exponentially, which is more indicative of the real risk people face, taking into account their activity restriction.
The FARE is recommended for use in public health policy and research on falls prevention because it takes into account reduced physical activity of older persons who experience increased difficulty controlling their balance.
常见的跌倒风险表达方式并不包括对危险环境的暴露。我们比较了两种表达方式：常用的人群发生率（每 1000 人年跌倒人数）和 FARE（通过暴露评估跌倒风险）：每 1000 个活跃人天的跌倒人数。
这是一项在荷兰开展的社区居住老年人（71-96 岁）的前瞻性随访研究（N=771）。在研究基线收集了年龄、性别、残疾（视力、行动能力）以及每周至少 30 分钟身体活动天数的数据。每月登记跌倒事件。使用每 1000 人年的跌倒人数和 FARE 来表示跌倒风险。平衡控制困难评分基于 11 项残疾项目的总和得分。
平衡控制困难程度的增加与危险环境暴露的减少（Spearman 相关系数=-.56）和每 1000 人年跌倒风险的增加呈线性相关。相比之下，FARE 评分呈指数增长，更能反映人们面临的实际风险，同时考虑到他们的活动受限情况。
建议在公共卫生政策和跌倒预防研究中使用 FARE，因为它考虑到了平衡控制能力增加的老年人身体活动减少的情况。
