Kang Li, Chen Xiaoyu, Han Peipei, Ma Yixuan, Jia Liye, Fu Liyuan, Yu Hairui, Wang Lu, Hou Lin, Yu Xing, An Zongyang, Wang Xuetong, Li Lu, Zhang Yuanyuan, Zhao Peng, Guo Qi
1 Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University , Tianjin, China .
2 Department of Rehabilitation Medicine, Tianjin Children Hospital , Tianjin, China .
Rejuvenation Res. 2018 Oct;21(5):416-422. doi: 10.1089/rej.2017.2005. Epub 2018 Jan 22.
The objective of this study was to determine falls risk profiles to derive a falls risk prediction score and establish a simple and practical clinical screening tool for Chinese community-dwelling elderly individuals. This was a prospective cohort study (n = 619) among adults aged 60 years and older. Falls were ascertained at a 1-year follow-up appointment. Sociodemographic information, medical history, and physical performance data were collected. The mean age was 67.4 years; 57.7% were women. Female sex (odds ratios [ORs] 1.82; 95% confidence interval [95% CI] 1.17-2.82), diabetes (OR 2.13; 95% CI 1.13-3.98), a Timed Up and Go Test (TUGT) ≥10.49 seconds (OR 1.51; 95% CI 1.23-1.94), a history of falls (OR 3.15; 95% CI 1.72-5.79), and depression (Geriatric Depression Scale [GDS] ≥11, OR 2.51; 95% CI 1.36-4.63) were the strongest predictors. These predictors were used to establish a risk score. The area under the curve of the score was 0.748. From a clinical point of view, the most appropriate cutoff value was 7 (97.5% specificity, 70.7% positive predictive value, and 83.6% negative predictive value). For this cutoff, the fraction correctly classified was 82.5%. A cutoff score of 7 derived from a risk assessment tool using four risk factors (gender, falls history, diabetes, and depression) and the TUGT may be used in Chinese community-dwelling elderly individuals as an initial step to screen those at low risk for falls.
本研究的目的是确定跌倒风险概况,以得出跌倒风险预测评分,并为中国社区居住的老年人建立一种简单实用的临床筛查工具。这是一项针对60岁及以上成年人的前瞻性队列研究(n = 619)。在1年的随访预约中确定跌倒情况。收集了社会人口统计学信息、病史和身体性能数据。平均年龄为67.4岁;57.7%为女性。女性(优势比[ORs] 1.82;95%置信区间[95% CI] 1.17 - 2.82)、糖尿病(OR 2.13;95% CI 1.13 - 3.98)、计时起立行走测试(TUGT)≥10.49秒(OR 1.51;95% CI 1.23 - 1.94)、跌倒史(OR 3.15;95% CI 1.72 - 5.79)和抑郁(老年抑郁量表[GDS]≥11,OR 2.51;95% CI 1.36 - 4.63)是最强的预测因素。这些预测因素被用于建立风险评分。该评分的曲线下面积为0.748。从临床角度来看,最合适的临界值为7(特异性97.5%,阳性预测值70.7%,阴性预测值83.6%)。对于这个临界值,正确分类的比例为82.5%。使用四个风险因素(性别、跌倒史、糖尿病和抑郁)以及TUGT得出的临界评分为7,可用于中国社区居住的老年人,作为筛查跌倒低风险人群的第一步。