社区居住老年人的邻里环境与跌倒情况

Neighborhood Environment and Falls among Community-Dwelling Older Adults.

作者信息

Nicklett Emily Joy, Lohman Matthew C, Smith Matthew Lee

机构信息

School of Social Work, The University of Michigan, Ann Arbor, MI 48109, USA.

Department of Psychiatry, Dartmouth Geisel School of Medicine, Lebanon, NH 03766, USA.

出版信息

Int J Environ Res Public Health. 2017 Feb 10;14(2):175. doi: 10.3390/ijerph14020175.

Abstract

: Falls present a major challenge to active aging, but the relationship between neighborhood factors and falls is poorly understood. This study examined the relationship between fall events and neighborhood factors, including neighborhood social cohesion (sense of belonging, trust, friendliness, and helpfulness) and physical environment (vandalism/graffiti, rubbish, vacant/deserted houses, and perceived safety walking home at night). : Data were analyzed from 9259 participants over four biennial waves (2006-2012) of the Health and Retirement Study (HRS), a nationally representative sample of adults aged 65 and older in the United States. : In models adjusting for demographic and health-related covariates, a one-unit increase in neighborhood social cohesion was associated with 4% lower odds of experiencing a single fall (odds ratio (OR): 0.96, 95% confidence interval (CI): 0.93-0.99) and 6% lower odds of experiencing multiple falls (OR: 0.94, 95% CI: 0.90-0.98). A one-unit increase in the physical environment scale was associated with 4% lower odds of experiencing a single fall (OR: 0.96, 95% CI: 0.93-0.99) and with 5% lower odds of experiencing multiple falls (OR: 0.95, 95% CI: 0.91-1.00) in adjusted models. : The physical and social neighborhood environment may affect fall risk among community-dwelling older adults. Findings support the ongoing need for evidence-based fall prevention programming in community and clinical settings.

摘要

跌倒对积极老龄化构成重大挑战,但邻里因素与跌倒之间的关系却鲜为人知。本研究考察了跌倒事件与邻里因素之间的关系,这些因素包括邻里社会凝聚力(归属感、信任、友好和乐于助人)以及物理环境(破坏行为/涂鸦、垃圾、空置/废弃房屋以及夜间步行回家时的安全感)。

数据来自健康与退休研究(HRS)的四轮两年期调查(2006 - 2012年)中的9259名参与者,该研究是美国65岁及以上成年人具有全国代表性的样本。

在对人口统计学和健康相关协变量进行调整的模型中,邻里社会凝聚力增加一个单位,经历单次跌倒的几率降低4%(优势比(OR):0.96,95%置信区间(CI):0.93 - 0.99),经历多次跌倒的几率降低6%(OR:0.94,95%CI:0.90 - 0.98)。在调整后的模型中,物理环境量表增加一个单位,经历单次跌倒的几率降低4%(OR:0.96,95%CI:0.93 - 0.99),经历多次跌倒的几率降低5%(OR:0.95,95%CI:0.91 - 1.00)。

邻里的物理和社会环境可能会影响社区居住老年人的跌倒风险。研究结果支持在社区和临床环境中持续开展基于证据的跌倒预防项目的必要性。

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