Hung Cheng-Hao, Wang Chih-Jen, Tang Ting-Ching, Chen Liang-Yu, Peng Li-Ning, Hsiao Fei-Yuan, Chen Liang-Kung
Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan.
Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.
Arch Gerontol Geriatr. 2017 May-Jun;70:214-218. doi: 10.1016/j.archger.2017.02.001. Epub 2017 Feb 4.
To evaluate the prevalence of recurrent falls and their risk factors among older men living in the Veterans Homes in Taiwan.
This cross-sectional study enrolled 871 residents and all participants received the comprehensive geriatric assessment, including Barthel Index, Mini-Mental Status Examination (MMSE), Geriatric Depression Scale-5 questions (GDS-5), Mini-Nutrition Assessment Short Form (MNA-SF), the status of urinary incontinence, stool incontinence, polypharmacy, past history of falls, multimorbidity, and medication history.
Overall, 871 subjects (mean age: 85.5±5.2years, all males) participated in this study, whereas 222(25.5%) of them had experienced falls in the past year, and 91 were recurrent fallers. Comparisons between non-fallers, single fallers and recurrent fallers disclosed that they were significantly different in the following characteristics: diabetes mellitus, chronic kidney disease, coronary artery disease, Charlson Comorbidity Index (CCI), Barthel Index, GDS-5, MNA-SF, polypharmacy, use of hypnotics, urinary incontinence, and stool incontinence (P for trend all <0.05). Multiple regression analysis identified that GDS-5 was significantly associated with single falls and recurrent falls (OR 1.256, 95% CI 1.094-1.441, P=0.001 for single fallers; OR 1.480, 95% CI 1.269-1.727, P<0.001 for recurrent fallers). Besides, urinary incontinence was the independently associated with recurrent fallers only (OR 2.369, 95% CI 1.449-3.817, P<0.001), but not single fallers.
Urinary incontinence and depressive symptoms were independent associated factors for falls among older men living in the retirement communities. However, urinary incontinence was associated with recurrent falls, but not single falls. Intervention study is needed to reduce recurrent falls through management of urinary incontinence.
评估台湾地区荣民之家老年男性反复跌倒的发生率及其危险因素。
这项横断面研究纳入了871名居民,所有参与者均接受了全面的老年综合评估,包括巴氏指数、简易精神状态检查表(MMSE)、老年抑郁量表5项问题(GDS-5)、微型营养评定简表(MNA-SF)、尿失禁状况、大便失禁状况、多重用药情况、既往跌倒史、多种疾病并存情况以及用药史。
总体而言,871名受试者(平均年龄:85.5±5.2岁,均为男性)参与了本研究,其中222人(25.5%)在过去一年中经历过跌倒,91人为反复跌倒者。非跌倒者、单次跌倒者和反复跌倒者之间的比较显示,他们在以下特征方面存在显著差异:糖尿病、慢性肾病、冠状动脉疾病、查尔森合并症指数(CCI)、巴氏指数、GDS-5、MNA-SF、多重用药情况、使用催眠药、尿失禁和大便失禁(趋势P值均<0.05)。多元回归分析确定,GDS-5与单次跌倒和反复跌倒显著相关(单次跌倒者的OR为1.256,95%CI为1.094-1.441,P=0.001;反复跌倒者的OR为1.480,95%CI为1.269-1.727,P<0.001)。此外,尿失禁仅与反复跌倒者独立相关(OR为2.369,95%CI为1.449-3.817,P<0.001),而与单次跌倒者无关。
尿失禁和抑郁症状是退休社区老年男性跌倒的独立相关因素。然而,尿失禁与反复跌倒相关,而与单次跌倒无关。需要进行干预研究,通过管理尿失禁来减少反复跌倒。