Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA; Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA.
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
Arch Gerontol Geriatr. 2017 Nov;73:240-247. doi: 10.1016/j.archger.2017.07.011. Epub 2017 Jul 21.
We sought to characterize the circumstances, orientations, and impact locations of falls in community-dwelling, ambulatory, older women.
For this longitudinal, observational study, 125 community-dwelling women age≥65years were recruited. Over 12-months of follow-up, fall details were recorded using twice-monthly questionnaires.
More than half (59%) of participants fell, with 30% of participants falling more than once (fall rate=1.3 falls per person-year). Slips (22%) and trips (33%) accounted for the majority of falls. Approximately 44% of falls were forward in direction, while backward falls accounted for 41% of falls. About a third of all falls were reported to have lateral (sideways) motion. Subjects reported taking a protective step in response to 82% of forward falls and 37% of backward falls. Of falls reporting lateral motion, a protective step was attempted in 70% of accounts. Common impact locations included the hip/pelvis (47% of falls) and the hand/wrist (27%). Backwards falls were most commonly reported with slips and when changing direction, and increased the risk of hip/pelvis impact (OR=12.6; 95% CI: 4.7-33.8). Forward falls were most commonly reported with trips and while hurrying, and increased the risk of impact to the hand/wrist (OR=2.6; 95% CI: 1.2-5.9).
Falls in older ambulatory women occur more frequently than previously reported, with the fall circumstance and direction dictating impact to common fracture locations. Stepping was a common protective recovery strategy and that may serve as an appropriate focus of interventions to reduce falls in this high risk population.
我们旨在描述居住在社区、行动自如的老年女性跌倒的情况、方向和撞击位置。
在这项纵向观察性研究中，招募了 125 名年龄≥65 岁的居住在社区的女性。在 12 个月的随访期间，使用每月两次的问卷记录跌倒细节。
超过一半（59%）的参与者跌倒，其中 30%的参与者跌倒不止一次（跌倒率=每人每年 1.3 次）。滑倒（22%）和绊倒（33%）占跌倒的大多数。大约 44%的跌倒是向前的，而向后跌倒占跌倒的 41%。大约三分之一的跌倒报告有侧向（侧面）运动。受试者报告在 82%的向前跌倒和 37%的向后跌倒中采取了保护性的一步。在报告有侧向运动的跌倒中，有 70%的尝试了保护性的一步。常见的撞击位置包括臀部/骨盆（47%的跌倒）和手/手腕（27%）。向后跌倒最常与滑倒和改变方向有关，增加了臀部/骨盆撞击的风险（OR=12.6；95%CI：4.7-33.8）。向前跌倒最常与绊倒和匆忙有关，增加了手/手腕撞击的风险（OR=2.6；95%CI：1.2-5.9）。
在行动自如的老年女性中，跌倒比以前报告的更常见，跌倒的情况和方向决定了常见骨折部位的撞击。跨步是一种常见的保护性恢复策略，这可能是减少该高风险人群跌倒的干预措施的一个适当重点。
