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老年人轻度阿尔茨海默病的跌倒风险评估。

Fall risk assessment among older adults with mild Alzheimer disease.

机构信息

Health First, Melbourne, FL, USA.

出版信息

J Geriatr Phys Ther. 2011 Jan-Mar;34(1):19-27. doi: 10.1519/JPT.0b013e31820aa829.

Abstract

PURPOSE

Older adults with Alzheimer disease (AD) fall more than twice as often as those without dementia, yet few studies have assessed fall risk in this population. The purpose of the study was to determine whether a fall assessment, the Physical Performance Test 7-item (PPT 7-item), could accurately identify subjects with history of falls in a group of community-dwelling elders with mild AD. An additional purpose was to determine whether the PPT 7-item, a cognitive screen, and/or nonperformance data could predict falling in this population.

METHODS

Forty-three community-dwelling elders diagnosed with mild AD completed the fall risk assessment. In addition, the following data were collected: Mini-Mental State Examination (MMSE) score, age, gender, education, gait aid use, number of falls in the past 6 months, and history of fall-related injury.

RESULTS

There was a significant difference in the PPT 7-item total score between subjects with history of falls and subjects without history of falls (z = -2.04, P = .042), with items related to turning (z = -2.56, P = .01) and walking (z = -2.89, P = .004) accounting for most of the difference. However, only gait aid usage predicted falling (45.8% of the variance).

CONCLUSION

While the PPT 7-item was able to detect differences in mobility between subjects with history of falls and subjects without history of falls in subjects with mild AD, total PPT 7-item score did not predict falling. Gait aid usage was more strongly related to falling in these subjects. Early detection of fall risk in individuals with mild AD is important to prevent injuries and moderate costs of care.

摘要

目的

患有阿尔茨海默病(AD)的老年人跌倒的频率是没有痴呆症的老年人的两倍多,但很少有研究评估该人群的跌倒风险。本研究旨在确定跌倒评估(物理性能测试 7 项,PPT 7 项)是否可以准确识别轻度 AD 社区居住老年人中有跌倒史的人群。另一个目的是确定 PPT 7 项、认知筛查和/或非表现数据是否可以预测该人群的跌倒。

方法

43 名被诊断为轻度 AD 的社区居住老年人完成了跌倒风险评估。此外,还收集了以下数据:简易精神状态检查(MMSE)评分、年龄、性别、教育程度、步态辅助用具使用情况、过去 6 个月内跌倒次数以及跌倒相关受伤史。

结果

有跌倒史的受试者和无跌倒史的受试者在 PPT 7 项总分上有显著差异(z=-2.04,P=.042),与转身(z=-2.56,P=.01)和行走(z=-2.89,P=.004)相关的项目差异最大。然而,只有步态辅助用具的使用预测了跌倒(占方差的 45.8%)。

结论

虽然 PPT 7 项能够检测到轻度 AD 受试者中有无跌倒史的受试者在移动能力方面的差异,但总 PPT 7 项评分并不能预测跌倒。在这些受试者中,步态辅助用具的使用与跌倒的关系更为密切。早期发现轻度 AD 个体的跌倒风险对于预防受伤和降低护理成本非常重要。

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