Helgadottir Bjorg, Moller Jette, Laflamme Lucie
Department of Public Health Sciences, Division of Public Health Epidemiology, Karolinska Institutet, Stockholm, Sverige, Sweden.
Department of Public Health Sciences, Division of Global Health/IHCAR, Karolinska Institutet, Stockholm, Sweden.
Age Ageing. 2015 Jul;44(4):604-10. doi: 10.1093/ageing/afv051. Epub 2015 Apr 22.
we identified clusters of older people with similar health-related behaviours and assessed the association between those clusters and the risk of injurious fall.
we linked self-reported and register-based data on the over-65s from the Stockholm public health cohort (N = 20,212). Groups of people with similar health-related behaviours were identified by cluster analysis using four measures of physical activity, two of smoking and alcohol habits and two individual attributes (age and type of housing). The association between clusters and falls leading to hospitalisation (422 cases) was studied using a nested case-control design. Odds ratios (ORs), crude and adjusted for health status, were compiled by cluster using the one with the most 'protective' health behaviour profile as the reference.
five clusters were identified revealing a variety of combinations of health-related behaviours, all linked to specific age groups and types of housing and with a tendency towards higher levels of physical activity among the younger ones. The risk of injurious falls differed across clusters, and for three out of four, it was significantly higher than in the comparison cluster. Adjusting for health status only partially reduced the ORs for those clusters and this was observed both in men and women.
health-related behaviours aggregate in different manners among older people. Some health-related profiles are associated with an excess risk of falls leading to hospitalisation. Although this is partly a reflection of age differences across clusters, health status alone cannot fully explain the association.
我们识别出具有相似健康相关行为的老年人集群,并评估这些集群与伤害性跌倒风险之间的关联。
我们将来自斯德哥尔摩公共卫生队列中65岁以上人群的自我报告数据和基于登记的数据进行了关联(N = 20,212)。通过聚类分析,使用身体活动的四项指标、吸烟和饮酒习惯的两项指标以及两项个体属性(年龄和住房类型),识别出具有相似健康相关行为的人群组。使用巢式病例对照设计研究集群与导致住院的跌倒之间的关联(422例病例)。以具有最“保护性”健康行为特征的集群为参照,按集群编制粗略的和根据健康状况调整后的比值比(OR)。
识别出五个集群,揭示了各种健康相关行为的组合,所有这些都与特定年龄组和住房类型相关,并且年轻人中身体活动水平有更高的趋势。不同集群中伤害性跌倒的风险有所不同,四分之三的集群中,其风险显著高于对照集群。仅对健康状况进行调整只能部分降低这些集群的OR,在男性和女性中均观察到这一点。
健康相关行为在老年人中以不同方式聚集。一些健康相关特征与导致住院的跌倒风险增加有关。虽然这部分反映了集群间的年龄差异,但仅健康状况不能完全解释这种关联。