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中国社区居住老年人的跌倒风险:一项生理特征评估研究。

Fall risk in Chinese community-dwelling older adults: A physiological profile assessment study.

作者信息

Siong Kar-Ho, Kwan Marcella Mun-San, Lord Stephen R, Lam Andrew Kwok-Cheung, Tsang William Wai-Nam, Cheong Allen Ming-Yan

机构信息

School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China.

Falls and Balance Research Group, Neuroscience Research Australia, Sydney, New South Wales, Australia.

出版信息

Geriatr Gerontol Int. 2016 Feb;16(2):259-65. doi: 10.1111/ggi.12463. Epub 2015 Feb 6.

Abstract

AIM

The short-form Physiological Profile Assessment (PPA) is increasingly used in clinical practice for assessing fall risk in older people. However, a normative database is only available for Caucasian populations. The purpose of the present study was to develop a normative database for Hong Kong Chinese older people and examine the fall risk profile of this population.

METHODS

A total of 622 participants aged 60-95 years were recruited. Participants underwent the PPA (containing tests of contrast sensitivity, proprioception, quadriceps strength, reaction time and sway), and composite fall risk scores were computed. Participants were then followed up for falls for 1 year.

RESULTS

Quadriceps strength and lower limb proprioception scores were comparable with those reported for Caucasian populations. However, contrast sensitivity, simple reaction time and postural sway scores were relatively poor. The average composite fall risk score was 1.7 ± 1.5, showing a "moderate" fall risk when compared with the Caucasian norms. Despite the relatively poor physical performances and moderately high fall risk scores, the incidence of one plus falls in the 1-year follow-up period was just 16.4%, with just 2.6% reporting two plus falls. The area under the curve for composite fall risk scores in discriminating fallers from non-fallers was 0.53 (95% CI 0.45-0.60).

CONCLUSIONS

Despite poorer performance in PPA tests, the incidence of prospective falls in a Hong Kong Chinese population was low. In consequence, the PPA could not discriminate well between fallers and non-fallers. The present study provided normality data for short-form PPA measures for older Chinese people as a reference for further studies.

摘要

目的

简版生理特征评估(PPA)在临床实践中越来越多地用于评估老年人的跌倒风险。然而,目前仅有针对白种人群体的常模数据库。本研究的目的是为中国香港的老年人建立一个常模数据库,并研究该人群的跌倒风险特征。

方法

共招募了622名年龄在60 - 95岁的参与者。参与者接受了PPA测试(包括对比敏感度、本体感觉、股四头肌力量、反应时间和摇摆测试),并计算了综合跌倒风险得分。然后对参与者进行为期1年的跌倒随访。

结果

股四头肌力量和下肢本体感觉得分与白种人群体报告的得分相当。然而,对比敏感度、简单反应时间和姿势摇摆得分相对较差。平均综合跌倒风险得分为1.7±1.5,与白种人常模相比显示出“中度”跌倒风险。尽管身体表现相对较差且跌倒风险得分中等偏高,但在1年随访期内一次及以上跌倒的发生率仅为16.4%,报告两次及以上跌倒的仅为2.6%。综合跌倒风险得分在区分跌倒者和非跌倒者方面的曲线下面积为0.53(95%可信区间0.45 - 0.60)。

结论

尽管在PPA测试中表现较差,但中国香港人群前瞻性跌倒的发生率较低。因此,PPA在区分跌倒者和非跌倒者方面表现不佳。本研究提供了中国老年人群简版PPA测量的常模数据,作为进一步研究的参考。

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