Department of Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA.
Am J Public Health. 2012 Nov;102(11):2149-56. doi: 10.2105/AJPH.2012.300677. Epub 2012 Sep 20.
We examined risk factors for falls among older people according to indoor and outdoor activity at the time of the fall and explored risk factors for seriously injurious falls.
Data came from MOBILIZE Boston, a prospective cohort study of 765 community-dwelling women and men, mainly aged 70 years or older. Over 4.3 years, 1737 falls were recorded, along with indoor or outdoor activity at the time of the fall.
Participants with poor baseline health characteristics had elevated rates of indoor falls while transitioning, walking, or not moving. Healthy, active people had elevated rates of outdoor falls during walking and vigorous activity. For instance, participants with fast, rather than normal, gait speed, had a rate ratio of 7.36 (95% confidence interval [CI] = 2.54, 21.28) for outdoor falls during vigorous activity. The likelihood of a seriously injurious fall also varied by personal characteristics, activity, and location. For example, the odds ratio for serious injury from an outdoor fall while walking outside compared to inside a participant's neighborhood was 3.31 (95% CI = 1.33, 8.23).
Fall prevention programs should be tailored to personal characteristics, activities, and locations.
根据跌倒时的室内和户外活动，研究老年人跌倒的危险因素，并探讨严重伤害性跌倒的危险因素。
数据来自波士顿 Mobilize 研究，这是一项针对 765 名居住在社区的女性和男性（主要年龄在 70 岁及以上）的前瞻性队列研究。在 4.3 年的时间里，共记录了 1737 次跌倒，以及跌倒时的室内或室外活动。
基线健康状况较差的参与者在过渡、行走或不活动时，室内跌倒的发生率较高。健康、活跃的人在行走和剧烈活动时，室外跌倒的发生率较高。例如，与正常步态速度相比，步态速度较快的参与者，在剧烈活动时发生户外跌倒的速率比为 7.36（95%置信区间[CI] = 2.54, 21.28）。严重伤害性跌倒的可能性也因个人特征、活动和地点而异。例如，与在参与者所在社区内室内跌倒相比，户外行走时严重受伤的户外跌倒的优势比为 3.31（95%CI = 1.33, 8.23）。
应根据个人特征、活动和地点定制跌倒预防计划。
