Department of Primary Care and Population Health, University College London (Royal Free Campus), Rowland Hill Street, London, NW3 2PF, UK.
School of Medicine, Division of Primary Care, University of Nottingham, Nottingham, UK.
BMC Geriatr. 2015 Dec 2;15:155. doi: 10.1186/s12877-015-0152-7.
Although population-based studies have shown frailty predicted future falls, their follow-up periods were one year or longer and short-term fall risks associated with frailty are unknown.
A prospective cohort study nested within a randomised controlled trial was conducted to examine associations between frailty and short-term incident future falls among community-dwelling older people. Two hundred forty eight community-dwelling people > =65 years without history of > =three falls and allocated to a usual care arm of exercise intervention trial were prospectively monitored for falls over 24 weeks. Frailty index (FI) was constructed from 40 deficits at baseline. The future fall risks according to frailty status was examined using logistic regression models.
Of 248 participants, 46 were classified as frail and 57 had one or more falls during follow-up. Both each 0.01 increase in FI and frailty defined as FI > =0.25 were significantly associated with higher risks of future falls in multivariate logistic regression models adjusted for age, gender and history of two falls in the previous year (odds ratio (OR) = 1.05, 95 % confidence interval (95 % CI) = 1.02-1.07, p < 0.001; OR = 3.04, 95 % CI = 1.53-6.02, p = 0.001, respectively). Receiver operating characteristic (ROC) curve analysis showed FI predicted future falls with fair accuracy with area under ROC curve of 0.62 (95 % CI = 0.53-0.71, p < 0.01).
Frailty was a significant and independent predictor of short-term future falls among community-dwelling older people who had volunteered for a physical activity study. It is important for healthcare practitioners to recognise frailty as a risk factor of imminent future falling even in older people who appear to be ageing well.
尽管基于人群的研究表明衰弱与未来跌倒有关，但这些研究的随访时间为一年或更长，而与衰弱相关的短期跌倒风险尚不清楚。
一项前瞻性队列研究嵌套在一项随机对照试验中，旨在研究社区居住的老年人衰弱与短期未来跌倒事件之间的关系。248 名社区居住的年龄≥65 岁、无≥3 次跌倒史且被分配至运动干预试验常规护理组的老年人被前瞻性监测 24 周内的跌倒情况。在基线时，使用 40 个缺陷构建衰弱指数（FI）。使用逻辑回归模型检查根据衰弱状态预测未来跌倒的风险。
在 248 名参与者中，46 名被归类为衰弱，57 名在随访期间发生了一次或多次跌倒。FI 每增加 0.01 和衰弱（FI≥0.25）在多变量逻辑回归模型中与未来跌倒的风险显著相关，该模型调整了年龄、性别和前一年两次跌倒的病史（比值比（OR）=1.05，95%置信区间（95 % CI）=1.02-1.07，p<0.001；OR=3.04，95 % CI=1.53-6.02，p=0.001）。接受者操作特征（ROC）曲线分析显示，FI 预测未来跌倒的准确性中等，ROC 曲线下面积为 0.62（95 % CI=0.53-0.71，p<0.01）。
衰弱是社区居住的老年人短期未来跌倒的一个显著和独立的预测因素，这些老年人自愿参加了一项体力活动研究。即使对于看起来衰老良好的老年人，医护人员也应将衰弱视为即将发生跌倒的危险因素。
