Nevitt M C, Cummings S R, Kidd S, Black D
Clinical Epidemiology Program, University of California, San Francisco 94143.
JAMA. 1989 May 12;261(18):2663-8.
Falls are a major threat to the health of older persons. We evaluated potential risk factors for falls in 325 community-dwelling persons aged 60 years or older who had fallen during the previous year, then followed up weekly for 1 year to ascertain nonsyncopal falls and their consequences. Risk factors for having a single fall were few and relatively weak, but multiple falls were more predictable. In multivariate analyses, we found increased odds of two or more falls for persons who had difficulty standing up from a chair, difficulty performing a tandem walk, arthritis, Parkinson's disease, three or more falls during the previous year, and a fall with injury during the previous year, and for whites. The proportion of subjects with two or more falls per year increased from 0.10 for those with none or one of these risk factors to 0.69 for those with four or more risk factors. Among older persons with a history of a recent fall, the risk of multiple nonsyncopal falls can be predicted from a few simple questions and examinations.
跌倒对老年人的健康构成重大威胁。我们评估了325名60岁及以上社区居住老人的跌倒潜在风险因素,这些老人在前一年曾跌倒过,随后每周随访1年,以确定非晕厥性跌倒及其后果。单次跌倒的风险因素较少且相对较弱,但多次跌倒更具可预测性。在多变量分析中,我们发现,从椅子上站起来困难、难以进行串联行走、患有关节炎、帕金森病、前一年跌倒3次或更多次、前一年跌倒并受伤的人以及白人,发生两次或更多次跌倒的几率增加。每年发生两次或更多次跌倒的受试者比例,从没有或只有其中一个风险因素的人中的0.10,增加到有四个或更多风险因素的人中的0.69。在近期有跌倒史的老年人中,通过一些简单的问题和检查就可以预测多次非晕厥性跌倒的风险。