健康老年人与年龄相关的跨步能力自我高估及其与跌倒风险的关系。
Age-related self-overestimation of step-over ability in healthy older adults and its relationship to fall risk.
机构信息
Health Promotion Science, Tokyo Metropolitan University, 1-1 Minami-Osawa, Hachioji-shi, Tokyo 192-0397, Japan.
出版信息
BMC Geriatr. 2013 May 7;13:44. doi: 10.1186/1471-2318-13-44.
BACKGROUND
Older adults could not safely step over an obstacle unless they correctly estimated their physical ability to be capable of a successful step over action. Thus, incorrect estimation (overestimation) of ability to step over an obstacle could result in severe accident such as falls in older adults. We investigated whether older adults tended to overestimate step-over ability compared with young adults and whether such overestimation in stepping over obstacles was associated with falls.
METHODS
Three groups of adults, young-old (age, 60-74 years; n, 343), old-old (age, >74 years; n, 151), and young (age, 18-35 years; n, 71), performed our original step-over test (SOT). In the SOT, participants observed a horizontal bar at a 7-m distance and estimated the maximum height (EH) that they could step over. After estimation, they performed real SOT trials to measure the actual maximum height (AH). We also identified participants who had experienced falls in the 1 year period before the study.
RESULTS
Thirty-nine young-old adults (11.4%) and 49 old-old adults (32.5%) failed to step over the bar at EH (overestimation), whereas all young adults succeeded (underestimation). There was a significant negative correlation between actual performance (AH) and self-estimation error (difference between EH and AH) in the older adults, indicating that older adults with lower AH (SOT ability) tended to overestimate actual ability (EH > AH) and vice versa. Furthermore, the percentage of participants who overestimated SOT ability in the fallers (28%) was almost double larger than that in the non-fallers (16%), with the fallers showing significantly lower SOT ability than the non-fallers.
CONCLUSIONS
Older adults appear unaware of age-related physical decline and tended to overestimate step-over ability. Both age-related decline in step-over ability, and more importantly, overestimation or decreased underestimation of this ability may raise potential risk of falls.
背景
老年人如果不能正确估计自己能够安全跨过障碍物的能力，就无法安全地跨过障碍物。因此，如果老年人对自己跨过障碍物的能力估计错误（高估），可能会导致跌倒等严重事故。我们调查了老年人是否比年轻人更容易高估跨过障碍物的能力，以及这种对跨过障碍物能力的高估是否与跌倒有关。
方法
三组成年人，年轻老年人（年龄，60-74 岁；n=343），老老年人（年龄，>74 岁；n=151）和年轻人（年龄，18-35 岁；n=71），进行了我们的原始跨步测试（SOT）。在 SOT 中，参与者观察 7 米远的水平杆，并估计他们可以跨过的最大高度（EH）。估计后，他们进行真实的 SOT 试验来测量实际的最大高度（AH）。我们还确定了在研究前 1 年内经历过跌倒的参与者。
结果
39 名年轻老年人（11.4%）和 49 名老老年人（32.5%）未能在 EH 处跨过横杆（高估），而所有年轻人都成功（低估）。在老年人中，实际表现（AH）与自我估计误差（EH 和 AH 之间的差异）之间存在显著的负相关，这表明 AH 较低（SOT 能力）的老年人往往高估实际能力（EH > AH），反之亦然。此外，高估 SOT 能力的跌倒者（28%）的比例几乎是低估者（16%）的两倍，跌倒者的 SOT 能力明显低于非跌倒者。
结论
老年人似乎没有意识到与年龄相关的身体衰退，并倾向于高估跨过障碍物的能力。跨步能力的年龄相关下降，更重要的是，对这种能力的高估或低估的减少，可能会增加跌倒的潜在风险。
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