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老年人躯干摆动定量分析与跌倒风险预测

Quantitative trunk sway and prediction of incident falls in older adults.

作者信息

Mahoney Jeannette R, Oh-Park Mooyeon, Ayers Emmeline, Verghese Joe

机构信息

Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Department of Neurology, Bronx, NY, USA.

Kessler Institute for Rehabilitation, Rutgers New Jersey Medical School, Department of Physical Medicine & Rehabilitation, West Orange, NJ, USA.

出版信息

Gait Posture. 2017 Oct;58:183-187. doi: 10.1016/j.gaitpost.2017.07.115. Epub 2017 Jul 29.

Abstract

Poor balance and balance impairments are major predictors of falls. The purpose of the current study was to determine the clinical validity of baseline quantitative static trunk sway measurements in predicting incident falls in a cohort of 287 community-dwelling non-demented older Americans (mean age 76.14±6.82years; 54% female). Trunk sway was measured using the SwayStar™ device, and quantified as angular displacement in degrees in anterior-posterior (pitch) and medio-lateral (roll) planes. Over a one-year follow-up period, 66 elders (23%) reported incident falls. Anterior-posterior angular displacement was a strong predictor of incident falls in older adults in Cox proportional hazards models (hazard ratio adjusted for age, gender, education, RBANS total score, medical comorbidities, geriatric depression scale score, sensory impairments, gait speed, and history of fall in the past 1year ((aHR)=1.59; p=0.033) whereas, angular displacement in the medio-lateral plane was not predictive of falls (aHR=1.35; p=0.276). Our results reveal the significance of quantitative trunk sway, specifically anterior-posterior angular displacement, in predicting incident falls in older adults.

摘要

平衡能力差和平衡功能受损是跌倒的主要预测因素。本研究的目的是确定在287名居住在社区的非痴呆美国老年人(平均年龄76.14±6.82岁;54%为女性)队列中,基线定量静态躯干摆动测量在预测跌倒事件方面的临床有效性。使用SwayStar™ 设备测量躯干摆动,并将其量化为前后(俯仰)和中外侧(横滚)平面上以度为单位的角位移。在一年的随访期内,66名老年人(23%)报告了跌倒事件。在Cox比例风险模型中,前后角位移是老年人跌倒事件的有力预测因素(根据年龄、性别、教育程度、RBANS总分、合并症、老年抑郁量表评分、感觉障碍、步态速度和过去1年的跌倒史调整后的风险比(aHR)=1.59;p=0.033),而中外侧平面的角位移不能预测跌倒(aHR=1.35;p=0.276)。我们的结果揭示了定量躯干摆动,特别是前后角位移,在预测老年人跌倒事件中的重要性。

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