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哪些类型的活动与老年人复发性跌倒的风险相关?

Which types of activities are associated with risk of recurrent falling in older persons?

机构信息

Department of Internal Medicine, Section Endocrinology, VU University Medical Center, Postbus 7057, 1007 MB Amsterdam, The Netherlands.

出版信息

J Gerontol A Biol Sci Med Sci. 2010 Jul;65(7):743-50. doi: 10.1093/gerona/glq013. Epub 2010 Feb 16.

Abstract

BACKGROUND

This study explored the associations between various types of activities, their underlying physical components, and recurrent falling in community-dwelling older persons.

METHODS

This study included 1,329 community-dwelling persons (>or=65 years) of the Longitudinal Aging Study Amsterdam (LASA). The time spent in walking, cycling, light and heavy household activities, and two sports was measured using the LASA Physical Activity Questionnaire (LAPAQ). Physical activity components included strength, intensity, mechanical strain, and turning. Time to second fall in a 6-month period was measured during 3 years with fall calendars. Cox proportional hazards models were adjusted for confounders and stratified for physical performance and sex in case of significant (p < .10) interaction.

RESULTS

During 3 years, 325 (24.5%) persons became recurrent fallers. In women, doing light (hazard ratios [HRs] = 0.40, 95% confidence intervals [CIs] = 0.20-0.79) or heavy household activities (HR = 0.63, CI = 0.44-0.79) was associated with a decreased risk of recurrent falling. In persons with good physical performance, doing sports (HR = 1.56, CI = 1.07-2.28), high intensity (HR > 1.75, CI = 1.09-3.16), and high mechanical strain (HR = 1.70, CI = 1.01-2.83) activities was associated with an increased risk of recurrent falling.

CONCLUSIONS

The results suggest that the relationship between physical activity and recurrent falling differs per type of activity and is modified by physical performance. Doing household activities was associated with a decreased risk of recurrent falling in women. In physically fit older persons, doing sports or activities with high intensity or mechanical strain demands was associated with an increased risk of recurrent falling.

摘要

背景

本研究探讨了社区老年人中各种活动类型、其潜在的身体活动成分与反复跌倒之间的关系。

方法

本研究纳入了阿姆斯特丹纵向老龄化研究(LASA)中的 1329 名社区居住者(年龄≥65 岁)。使用 LASA 体力活动问卷(LAPAQ)测量步行、骑车、轻体力活动和重体力活动以及两种运动的时间。体力活动成分包括力量、强度、机械应变和转身。在 3 年期间,使用跌倒日历测量了 6 个月内的第二次跌倒时间。在存在显著(p<.10)交互作用的情况下,使用 Cox 比例风险模型对混杂因素进行调整,并按身体表现和性别分层。

结果

在 3 年期间,有 325 名(24.5%)人成为反复跌倒者。在女性中,从事轻体力(HR=0.40,95%置信区间[CI]:0.20-0.79)或重体力家务活动(HR=0.63,CI:0.44-0.79)与反复跌倒风险降低相关。在身体表现良好的人群中,从事运动(HR=1.56,CI:1.07-2.28)、高强度(HR>1.75,CI:1.09-3.16)和高机械应变(HR=1.70,CI:1.01-2.83)活动与反复跌倒风险增加相关。

结论

结果表明,体力活动与反复跌倒之间的关系因活动类型而异,并受身体表现的影响。女性从事家务活动与反复跌倒风险降低相关。在身体状况良好的老年人中,从事运动或高强度或机械应变要求的活动与反复跌倒风险增加相关。

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