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轻度至中度智力障碍老年人跌倒风险因素的前瞻性研究。

Prospective study on risk factors for falling in elderly persons with mild to moderate intellectual disabilities.

机构信息

Radboud University Medical Centre, Nijmegen Centre for Evidence Based Practice, Department of Rehabilitation, Nijmegen, The Netherlands.

出版信息

Res Dev Disabil. 2013 Nov;34(11):3754-65. doi: 10.1016/j.ridd.2013.07.041. Epub 2013 Sep 9.

Abstract

Elderly persons with intellectual disabilities (ID) are at increased risk for falls and fall-related injuries. Although there has been extensive research on risk factors for falling in the general elderly population, research on this topic in persons with ID is rather sparse. This is the first study to prospective investigate risk factors for falling among elderly persons with mild to moderate ID. Seventy-eight ambulatory persons with mild to moderate ID (mean age 62.8 ± 7.6 years; 44 (56%) men; 34 (44%) mild ID) participated in this study. This longitudinal cohort study involved extensive baseline assessments, followed by a one-year follow-up on fall incidents. Falls occurred in 46% of the participants and the fall rate was 1.00 falls per person per year. The most important risk factors for falling in elderly persons with mild to moderate ID were (mild) severity of ID, (high) physical activity, (good) visuo-motor capacity, (good) attentional focus and (high) hyperactivity-impulsiveness, which together explained 56% of the fall risk. This pattern of risk factors identified suggests a complex interplay of personal and environmental factors in the aetiology of falls in elderly persons with ID. We recommend further research on the development of multifactorial screening procedures and individually tailored interventions to prevent falling in persons with ID.

摘要

智力障碍老年人(ID)跌倒和跌倒相关伤害的风险增加。尽管已经有大量关于一般老年人群体跌倒风险因素的研究,但在 ID 人群中对此主题的研究却相当稀少。这是第一项前瞻性研究轻度至中度 ID 老年人跌倒风险因素的研究。78 名轻度至中度 ID(平均年龄 62.8 ± 7.6 岁;44 名男性,占 56%;34 名女性,占 44%)的能走动的人参加了这项研究。这项纵向队列研究包括广泛的基线评估,随后进行了为期一年的跌倒事件随访。46%的参与者发生了跌倒,跌倒率为 1.00 人/年。轻度至中度 ID 老年人跌倒的最重要风险因素是(轻度)ID 严重程度、(高)身体活动、(良好)视动能力、(良好)注意力集中和(高)多动冲动性,这些因素共同解释了 56%的跌倒风险。确定的这种风险因素模式表明,个人和环境因素在 ID 老年人跌倒的发病机制中存在复杂的相互作用。我们建议进一步研究开发多因素筛查程序和个体化干预措施,以预防 ID 患者跌倒。

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