Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, Ontario, Canada.
J Patient Saf. 2010 Sep;6(3):187-91. doi: 10.1097/pts.0b013e3181f1251c.
Despite the significance of falling, fear of falling may represent a greater pervasive concern to the health of seniors. Activity restriction, resulting from fear of falling, which may or may not develop after a fall, may lead to balance deterioration, functional decline, anxiety or reductions in social/leisure/physical activity opportunities, and, consequently, compromised quality of life and health.
The purpose of this research was to determine the risk factors for activity restriction resulting from fear of falling among community-based seniors using an early version of the interRAI Community Health Assessment (interRAI CHA). All participants (n = 560) were enrolled in 1 of 5 different fall intervention programs in Ontario funded through the Falls Prevention Initiative sponsored by Health Canada and Veterans Affairs Canada. All participants (or a predetermined number of seniors if the subject pool was extensive) were assessed both before and after intervention. Subjects were assessed using the interRAI CHA.
Thirty-five percent of seniors reported restricting their activity as a result of fear of falling. Risk factors predictive of activity restriction included previous history of falling, compromised instrumental activities of daily living, compromised cognitive performance, presence of pain, female sex, and impaired gait.
Fear of falling is a prevalent issue among seniors, which has the potential to alter their quality of life and morbidity, and as such, including fear of falling in public health programs, health policies, and screening efforts seems imperative. The present findings add to the present research on risk factors for activity restriction because of fear of falling. These findings do not advocate for restriction of activity to prevent falls because restriction is not a good solution to fall prevention. Using a standardized and comprehensive tool such as the interRAI CHA would assist researchers in making comparisons between different research groups as well as assessing fear of falling from a multidisciplinary perspective.
尽管跌倒意义重大,但老年人可能更担心跌倒恐惧,这会对其健康造成更普遍的影响。由于害怕跌倒而导致的活动受限,可能会在跌倒后或之前发生,这可能会导致平衡恶化、功能下降、焦虑或减少社交/休闲/体育活动机会,从而降低生活质量和健康水平。
本研究旨在使用早期版的 interRAI 社区健康评估(interRAI CHA)确定社区老年人因害怕跌倒而导致活动受限的风险因素。所有参与者(n=560)均参加了安大略省由加拿大卫生部和加拿大退伍军人事务部资助的 5 个不同跌倒干预计划中的 1 个。所有参与者(或如果研究对象范围广泛,则为预先确定的一定数量的老年人)在干预前后都接受了评估。使用 interRAI CHA 对参与者进行评估。
35%的老年人因害怕跌倒而限制了自己的活动。与活动受限相关的预测因素包括既往跌倒史、日常生活活动能力受损、认知功能受损、疼痛、女性、以及步态受损。
跌倒恐惧在老年人中是一个普遍存在的问题,它有可能改变他们的生活质量和发病率,因此,将其纳入公共卫生计划、卫生政策和筛查工作似乎势在必行。本研究结果增加了目前关于因害怕跌倒而导致活动受限的风险因素的研究。这些结果并不是提倡为了预防跌倒而限制活动,因为限制活动并不是预防跌倒的好方法。使用标准化和全面的工具,如 interRAI CHA,将有助于研究人员在不同研究组之间进行比较,并从多学科的角度评估跌倒恐惧。