Center for Hip Health and Mobility, University of British Columbia, Vancouver, British Columbia, Canada; Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada.
Center for Hip Health and Mobility, University of British Columbia, Vancouver, British Columbia, Canada; Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada.
J Am Med Dir Assoc. 2018 Feb;19(2):130-135.e1. doi: 10.1016/j.jamda.2017.08.011. Epub 2017 Sep 28.
Falls are a major health concern for older adults. Understanding sex differences in fall circumstances may guide the design of fall management plans specifically to men and women. In this study, analyzed real-life falls captured on video to compare scenarios leading to falls between men and women in 2 long-term care (LTC) facilities.
Prospective cohort study.
PARTICIPANTS/SETTING: A total of 529 participants residing in 2 LTC facilities in British Columbia, Canada.
Between 2008 and 2016, we video-captured 1738 falls experienced by 231 men and 298 women (mean age = 83 ± 9 years). Each video was analyzed to determine the causes of imbalance and the activities at time of falling. Using generalized estimating equation models, we examined how fall circumstances associated with age, sex, and health status.
Men were more likely than women to fall from loss of support with an external object (odds ratio 1.37; 95% confidence interval 1.08-1.73) and less likely to fall from tripping (0.72; 0.54-0.96). Men were more likely to fall while seated (1.42; 1.07-1.87) or while rising (1.49; 1.11-1.99), and less likely to fall while walking (0.61; 0.50-0.75). After adjusting for age and health status, sex remained significantly associated with loss of support and walking. Furthermore, regardless of sex, falls from loss of support were more common among individuals who were less independent in activities of daily living, who used more medications, and who used diuretic. Individuals with independent activities of daily living and intact cognition were more likely to fall while walking, but less likely to fall while seated or while rising.
Our results elucidate differences between older men and women in the scenarios that lead to falls, to inform sex-specific fall prevention strategies in the LTC setting.
跌倒对老年人来说是一个严重的健康问题。了解跌倒情况中的性别差异可能有助于专门为男性和女性制定跌倒管理计划。本研究通过分析视频中记录的真实跌倒事件，比较了 2 家长期护理（LTC）机构中男性和女性跌倒的情况。
前瞻性队列研究。
参与者/设置：共有 529 名参与者，分别居住在加拿大不列颠哥伦比亚省的 2 家 LTC 机构。
2008 年至 2016 年，我们共拍摄了 231 名男性和 298 名女性的 1738 次跌倒事件（平均年龄 83 ± 9 岁）。每个视频都进行了分析，以确定失去平衡的原因和跌倒时的活动情况。我们使用广义估计方程模型，研究了与年龄、性别和健康状况相关的跌倒情况。
男性跌倒时更有可能是因为失去外部物体的支撑（优势比 1.37；95%置信区间 1.08-1.73），而较少是因为绊倒（0.72；0.54-0.96）。男性更有可能在坐着（1.42；1.07-1.87）或起身（1.49；1.11-1.99）时跌倒，而较少在行走（0.61；0.50-0.75）时跌倒。调整年龄和健康状况后，性别与失去支撑和行走仍有显著关联。此外，无论性别如何，失去支撑的跌倒在日常生活活动独立性较低、使用更多药物和利尿剂的个体中更为常见。日常生活活动独立性高且认知能力完整的个体更有可能在行走时跌倒，但较少在坐着或起身时跌倒。
我们的研究结果阐明了老年男性和女性在导致跌倒的情况方面的差异，为在长期护理环境中制定针对特定性别的跌倒预防策略提供了信息。
