The Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Krakow, Poland.
Exp Gerontol. 2013 Feb;48(2):140-6. doi: 10.1016/j.exger.2012.12.003. Epub 2012 Dec 20.
Falls are a geriatric syndrome which affects the physical and psychological well-being of the aged. So far, in Poland there have not been any population-based data on the prevalence of falls among the elderly. The aim of this analysis was to assess the prevalence of falls, their circumstances and consequences in the Polish population aged 65 years and older in comparison to younger respondents aged 55-59 years, and the relation of falls to visual and hearing deficits. Mean age of the 4920 elderly subjects (51.6% men) was 79.4±8.7 years. Falls in the past year were reported by 10.4% of the younger and 19.1% of the older subjects. In both groups falls occurred more frequently in women (11.9% vs. 8.7%, p=0.03 in the younger and 22.7% vs. 13.2%, p<0.001 in the older group). In the group of older subjects falls occurred most often during walking (66.7% vs. 50.7% in the group of 55-59 years old), p=0.005), while the younger more often fell while practicing sports (5.48% vs. 0.8% in the group 65+, p<0.001) and risky activities (respectively: 13.7% vs. 4.9%, p=0.002). A similar percentage of younger and older fallers reported one (44.0% and 46.1% respectively) or more falls (56.1% and 53.9%; p=0.6). The percentage of recurrent fallers grew with increasing age (Cc=0.177; p<0.001). The prevalence of injurious falls was similar in the younger and older groups (45.4% and 42.8%, p=0.53). In both genders fall-related injuries were more frequent in younger elderly (65-74 years old) and in subjects 90 years old and older. In the non-standardized analysis and after adjustment for age and gender visual and hearing impairments and its degree were associated with falls but both relations lost statistical significance after adjustment for a set of explanatory variables. Despite somewhat lower estimates, falls in older Poles are no less an important factor influencing overall health than in other populations. The higher prevalence of multiple falls should draw attention of the health-care policy makers. Sensory impairment may add to the risk of falls and should be adequately taken care of, however the priority in the future fall prevention initiative should be given to stronger factors, such as age, type of activity, overall health, cognitive function and functional status.
跌倒属于老年综合征,会影响老年人的身心健康。目前,波兰尚无针对老年人跌倒流行情况的基于人群的相关数据。本分析旨在评估波兰 65 岁及以上老年人跌倒的发生率、发生情况和后果,并研究跌倒与视觉和听觉缺陷之间的关系。4920 名老年人(51.6%为男性)的平均年龄为 79.4±8.7 岁。过去一年中,年轻组(55-59 岁)中有 10.4%的人报告跌倒,而年长组(65 岁及以上)中有 19.1%的人报告跌倒。在两个组中,女性跌倒的发生率均高于男性(年轻组为 11.9%比 8.7%,p=0.03;年长组为 22.7%比 13.2%,p<0.001)。在年长组中,跌倒最常发生在行走过程中(66.7%比 50.7%,p=0.005),而在年轻组中,跌倒更常发生在运动时(5.48%比 0.8%,p<0.001)和危险活动时(分别为 13.7%比 4.9%,p=0.002)。年轻和年长跌倒者报告一次或多次跌倒的比例相似(分别为 44.0%和 46.1%)(56.1%和 53.9%;p=0.6)。随着年龄的增长,复发性跌倒者的比例也随之增加(Cc=0.177;p<0.001)。受伤跌倒的发生率在年轻组和年长组中相似(分别为 45.4%和 42.8%,p=0.53)。在两性中,跌倒相关损伤在年轻老年人(65-74 岁)和 90 岁及以上的人群中更为常见。在非标准化分析和调整年龄和性别因素后,视觉和听觉损伤及其严重程度与跌倒相关,但在调整了一组解释变量后,这两种关系均失去了统计学意义。尽管跌倒发生率略低,但波兰老年人的跌倒问题与其他人群一样,是影响整体健康的一个重要因素。多发性跌倒的高发生率应引起医疗保健政策制定者的关注。感觉障碍可能会增加跌倒的风险,应予以充分重视,但在未来的跌倒预防工作中,应优先考虑年龄、活动类型、整体健康状况、认知功能和功能状态等更强有力的因素。