Division of Geriatric Medicine, Department of Health Sciences, Skåne University Hospital, Lund University, SE-205 02, Malmö, Sweden.
Aging Clin Exp Res. 2013 Apr;25(1):59-67. doi: 10.1007/s40520-013-0015-z. Epub 2013 Feb 21.
The aim of this study was to describe the prevalence of falls in a general older population, especially among the most elderly, and the risk markers associated with falls.
This is a cross-sectional study in which 38 fall risk markers were analysed in non-, occasional- and frequent-fallers. The population was 2,865 individuals (aged 60-93), randomly selected from the general population register. The risk of falling was calculated as age-adjusted odds ratios. The relation between the number of risk markers for an individual and falls was also analysed.
About one in ten reported falling during the past 6 months, 35% of which were over 90 years old. Twenty-one risk markers were significantly related to falls confirming falling as a multifactorial problem. These included a variety of diseases, symptoms, medical and physical functions, life-style factors and the taking of certain drugs. The five risk markers with the highest odds ratio in frequent fallers were 'tendency to fall' (37.9), 'low walking speed' (12.8), consumption of 'neuroleptics' (10.9), 'impaired mobility' (10.0) and 'dementia' (5.4). Subjects with more than four and seven risk markers showed a 9- respectively 28-fold increase in the risk of falling, especially among frequent fallers and those aged over 90 years.
Falls are common in the elderly population and the risk is multifactorial. The results imply that there is an overrepresentation of fallers in a distinct subgroup of the very elderly and those with multiple risk markers. The self-perceived clinical sign 'tendency to fall' seems highly sensitive as indicator of individuals at risk. Several risk markers may be treatable. Fall risk seems to increase in a non-linear, almost exponential way with increasing number of risk markers.
本研究旨在描述一般老年人群中跌倒的发生率，尤其是在最年长的人群中，以及与跌倒相关的风险标志物。
这是一项横断面研究，分析了非跌倒者、偶发性跌倒者和频繁跌倒者中的 38 个跌倒风险标志物。该人群由 2865 名（年龄 60-93 岁）随机选自一般人群登记处的个体组成。跌倒风险的计算方法为年龄调整后的优势比。还分析了个体的风险标志物数量与跌倒之间的关系。
约十分之一的人报告在过去 6 个月内跌倒，其中 35%的人年龄在 90 岁以上。21 个风险标志物与跌倒显著相关，证实跌倒是一个多因素问题。这些标志物包括各种疾病、症状、医疗和身体功能、生活方式因素以及某些药物的使用。在频繁跌倒者中，风险比最高的五个风险标志物是“易跌倒倾向”（37.9）、“步行速度低”（12.8）、“使用神经阻滞剂”（10.9）、“活动能力受损”（10.0）和“痴呆”（5.4）。有超过四个和七个风险标志物的受试者跌倒风险分别增加 9 倍和 28 倍，尤其是在频繁跌倒者和 90 岁以上的人群中。
跌倒在老年人群中很常见，风险是多因素的。结果表明，在非常年长的人群和具有多个风险标志物的人群中，跌倒者的比例过高。自我感知的临床征象“易跌倒倾向”似乎是一个高度敏感的风险指标。一些风险标志物可能是可治疗的。随着风险标志物数量的增加，跌倒风险呈非线性增加，几乎呈指数级增加。
