Landy David C, Mintzer Michael J, Dearwater Stephen R, Graygo Jill A, Schulman Carl I
Department of Epidemiology and Public Health, Geriatrics Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
South Med J. 2012 Aug;105(8):405-10. doi: 10.1097/SMJ.0b013e31825efc70.
Fatal falls cause more than 15,000 deaths per year in the United States. Despite this, the circumstances surrounding fatal falls in elderly adults are poorly understood. It is unknown whether these circumstances differ across ethnicities, although Hispanic American individuals are at reduced risk for fatal falls. This study sought to describe fatal falls in an urban, predominantly Hispanic, and white non-Hispanic community and to determine the association of demographics with the circumstances surrounding these falls (proximate factors).
The death certificates and medical examiners' reports for all 328 elderly individuals experiencing a fatal fall in Miami-Dade County, FL, from 2005 to 2007 were reviewed for demographic and proximate factors such as the preceding activity and fall location.
Fatal falls in elderly adults were experienced mostly by individuals living in the community (80%) and affected all demographic subgroups, although 80% occurred in individuals older than 74 years. Most fatal falls occurred at home (74%), indoors (75%), and during nonvigorous activities such as walking (58%) and these tended to affect the oldest elderly. In addition, a significant number of fatal falls occurred in public locations, outdoors, and during vigorous activity, with these falls tending to affect younger individuals living without family. Hispanic ethnicity was not associated with proximate factors.
Fatal fall prevention is needed for elderly individuals living in the community and should target the oldest elderly adults living at home while helping to ensure that individuals who are living without family have the appropriate support. These data suggest that Hispanic individuals may benefit from prevention strategies developed in other populations.
在美国,每年有超过15,000人死于致命跌倒。尽管如此,人们对老年人致命跌倒的相关情况却知之甚少。虽然西班牙裔美国人发生致命跌倒的风险较低,但尚不清楚这些情况在不同种族之间是否存在差异。本研究旨在描述一个以西班牙裔和非西班牙裔白人为主的城市社区中的致命跌倒情况,并确定人口统计学因素与这些跌倒相关情况(近端因素)之间的关联。
回顾了2005年至2007年在佛罗里达州迈阿密-戴德县发生致命跌倒的所有328名老年人的死亡证明和法医报告,以获取人口统计学和近端因素,如跌倒前的活动和跌倒地点。
老年人中的致命跌倒大多发生在社区居民中(80%),并影响到所有人口亚组,不过80%的跌倒发生在74岁以上的人群中。大多数致命跌倒发生在家中(74%)、室内(75%)以及诸如行走(58%)等非剧烈活动期间,而这些情况往往影响年龄最大的老年人。此外,相当数量的致命跌倒发生在公共场所、户外以及剧烈活动期间,这些跌倒往往影响没有家人陪伴的较年轻个体。西班牙裔与近端因素无关。
需要针对社区中的老年人开展预防致命跌倒的工作,并且应将目标对准在家居住的年龄最大的老年人,同时要确保没有家人陪伴的个体能得到适当的支持。这些数据表明,西班牙裔个体可能会从针对其他人群制定的预防策略中受益。