Dias Rosângela C, Freire Maria T F, Santos Erika G S, Vieira Renata A, Dias João M D, Perracini Mônica R
Physical Therapy Department, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil.
Rev Bras Fisioter. 2011 Sep-Oct;15(5):406-13.
The aim of this study was to determine the social-demographic, clinical, functional and psychological factors associated to activity restriction due to fear of falling in community-dwelling elderly and identify which variables best discriminate groups of elderly with different levels of activity restriction and fear of falling.
One hundred and thirteen community-dwelling elderly (74.5±7 years old) participated in the study. Activity restriction induced by fear of falling, previous falls, fall related self-efficacy, frailty phenotype, functional capacity, depressive symptoms, health self-perception, socio-demographic and clinical factors were assessed. Descriptive statistics, chi-square, ANOVA and Kruskal Wallis tests were used to analyze the associations between activity restriction due to fear of falling and all other variables. Path analysis (CHAID) method was used to verify which variables better discriminated groups in relation to activity restriction (α=0.05).
The participants who reported fear of falling and activity restriction demonstrated higher depression (p=0.038), lower fall related self-efficacy (p<0.001), lower gait velocity (p=0.043) and independence level for instrumental daily living activities (p=0.017), higher number of diseases (p=0.048), worse health self-perception (p=0.040) and more depressive symptom (p=0.023). The best variables to discriminate groups were depression (p=0.004), exhaustion (frailty phenotype) (p=0.010) and social participation activities (p=0.016).
Activity restriction due to fear of falling may have negative effects on functional capacity and psychological aspects in community-dwelling elderly. Psychosocial factors seem to better discriminate the elderly who avoid activities due to fear of falling.
本研究旨在确定与社区居住老年人因害怕跌倒而导致活动受限相关的社会人口学、临床、功能和心理因素,并确定哪些变量能最佳区分不同活动受限水平和害怕跌倒程度的老年人群体。
113名社区居住老年人(74.5±7岁)参与了本研究。评估了因害怕跌倒导致的活动受限、既往跌倒史、与跌倒相关的自我效能感、衰弱表型、功能能力、抑郁症状、健康自我认知、社会人口学和临床因素。采用描述性统计、卡方检验、方差分析和克鲁斯卡尔-沃利斯检验来分析因害怕跌倒导致的活动受限与所有其他变量之间的关联。使用路径分析(CHAID)方法来验证哪些变量在区分活动受限群体方面表现更佳(α=0.05)。
报告害怕跌倒和活动受限的参与者表现出更高的抑郁水平(p=0.038)、更低的与跌倒相关的自我效能感(p<0.001)、更低的步态速度(p=0.043)和工具性日常生活活动的独立水平(p=0.017)、更多的疾病数量(p=0.048)、更差的健康自我认知(p=0.040)和更多的抑郁症状(p=0.023)。区分不同群体的最佳变量是抑郁(p=0.004)、疲惫(衰弱表型)(p=0.010)和社会参与活动(p=0.016)。
因害怕跌倒导致的活动受限可能会对社区居住老年人的功能能力和心理方面产生负面影响。社会心理因素似乎能更好地区分因害怕跌倒而避免活动的老年人。