Perracini Monica R, Teixeira Luiza F, Ramos Juliane L A, Pires Raquel S, Najas Myrian S
Program in Physical Therapy, Universidade da Cidade de São Paulo, São Paulo, SP, Brazil.
Rev Bras Fisioter. 2012 Apr;16(2):166-72. doi: 10.1590/s1413-35552012005000009. Epub 2012 Mar 1.
Fall-related factors in older adults with different levels of physical activity, within a multidimensional approach, have not been widely investigated.
To explore fall-related factors among older adults with different physical activity levels.
A cross-sectional, exploratory study with 118 older adult outpatients. Participants who reported at least one fall in the previous 12 months were considered fallers. The activity level was assessed through the Human Activity Profile. A cutoff of 54 points was used to define the less active group and the more active group. A multidimensional questionnaire and a set of physical functioning tests were applied.
Fall prevalence was lower among the more active older adults (47.4%) when compared with the less active older adults (71.4%) (p<0.013). Logistic regression analysis showed that, among the more active group, falls were associated with: depressive symptoms (OR=0.747, 95%CI=0.575-0.970; p=0.029), concern about falling (OR=1.17, 95%CI=1.072-1.290; p=0.001), and self-selected walking speed (OR=0.030, 95%CI=0.004-0.244; p=0.001). For the less active group, the model was composed of age (OR=1.197, 95%CI=1.032-1.387; p=0.017) and functional disability (OR=14.447, 95%CI=1.435-145.45; p=0.023).
For the more active older adults, reduced self-efficacy suggests that falling can trigger some protective behavior, such as slower gait and depressive symptoms, but the casual link between falls and these outcomes should be further investigated. These data emphasize that physical therapists should be aware that there are differences in fall-related factors depending on the older patients' physical activity level, and this must be considered when planning interventions for this population.
在多维度方法中,不同身体活动水平的老年人跌倒相关因素尚未得到广泛研究。
探讨不同身体活动水平老年人的跌倒相关因素。
对118名老年门诊患者进行横断面探索性研究。报告在过去12个月中至少跌倒一次的参与者被视为跌倒者。通过人类活动概况评估活动水平。使用54分的临界值来定义活动较少组和活动较多组。应用了一份多维度问卷和一组身体功能测试。
与活动较少的老年人(71.4%)相比,活动较多的老年人跌倒患病率较低(47.4%)(p<0.013)。逻辑回归分析表明,在活动较多的组中,跌倒与以下因素相关:抑郁症状(OR=0.747,95%CI=0.575-0.970;p=0.029)、对跌倒的担忧(OR=1.17,95%CI=1.072-1.290;p=0.001)和自选步行速度(OR=0.030,95%CI=0.004-0.244;p=0.001)。对于活动较少的组,模型由年龄(OR=1.197,95%CI=1.032-1.387;p=0.017)和功能残疾(OR=14.447,95%CI=1.435-145.45;p=0.023)组成。
对于活动较多的老年人,自我效能降低表明跌倒可能引发一些保护行为,如步态减慢和抑郁症状,但跌倒与这些结果之间的因果关系应进一步研究。这些数据强调,物理治疗师应意识到,根据老年患者的身体活动水平,跌倒相关因素存在差异,在为该人群制定干预措施时必须考虑这一点。