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导致中老年日本成年人在家中跌倒和跌倒相关骨折的环境和身体因素。

Environmental and physical factors predisposing middle-aged and older Japanese adults to falls and fall-related fractures in the home.

机构信息

Graduate School of Medicine, University of Tokyo, Tokyo, Japan.

Institute of Gerontology, Faculty of Engineering, University of Tokyo, Tokyo, Japan.

出版信息

Geriatr Gerontol Int. 2018 Sep;18(9):1372-1377. doi: 10.1111/ggi.13494. Epub 2018 Aug 21.

Abstract

AIM

To identify environmental and physical factors that predispose middle-aged and older Japanese adults to falls and fall-related fractures in the home.

METHODS

A cross-sectional survey was carried out in 2014. Self-administered questionnaires were distributed to 15 000 community-dwelling adults in Japan. The overall crude response rate was 13%. Response data were analyzed from 1561 individuals aged ≥40 years using multiple imputation to analyze missing data. We evaluated falls without fractures and fall-related fractures during the previous 3 years according to demographic, physical and environmental factors, including age, sex, long-term care insurance certification, type of house and barrier-free housing.

RESULTS

Of the 1561 adults (mean age 68.1 ± 13.0 years), 28% experienced a fall in the home. Among the individuals who experienced a fall, 11% experienced fall-related fractures. These individuals were more likely to be women (OR 2.4, 95.0% CI 1.1-5.1), have LTCI certification (OR 3.9, 95.0% CI 1.6-9.4) and be living in a barrier home (OR 4.0, 95.0% CI 1.6-9.8), after adjustment for covariates.

CONCLUSIONS

Environmental factors, such as living in a barrier home, are critical for fall-related fractures, in addition to demographic and physical factors. A multidisciplinary approach that considers both physical and environmental factors is necessary for reducing the incidence of fall-related fractures among middle-aged and older Japanese adults. Geriatr Gerontol Int 2018; 18: 1372-1377.

摘要

目的

确定导致中老年日本成年人在家中跌倒和跌倒相关骨折的环境和身体因素。

方法

2014 年进行了一项横断面调查。向日本 15000 名居住在社区的成年人发放了自我管理问卷。总体粗应答率为 13%。使用多重插补分析缺失数据,对年龄≥40 岁的 1561 名个体的应答数据进行了分析。我们根据人口统计学、身体和环境因素(包括年龄、性别、长期护理保险认证、房屋类型和无障碍住房)评估了过去 3 年内无骨折跌倒和跌倒相关骨折。

结果

在 1561 名成年人(平均年龄 68.1±13.0 岁)中,28%的人在家中跌倒。在跌倒的个体中,11%的人发生跌倒相关骨折。这些人更有可能是女性(OR 2.4,95.0%CI 1.1-5.1)、有 LTCI 认证(OR 3.9,95.0%CI 1.6-9.4)和居住在无障碍住房中(OR 4.0,95.0%CI 1.6-9.8),调整了协变量后。

结论

除了人口统计学和身体因素外,环境因素,如居住在无障碍住房中,对跌倒相关骨折至关重要。考虑到身体和环境因素的多学科方法对于降低中老年日本成年人跌倒相关骨折的发生率是必要的。老年医学与老年病学国际 2018;18:1372-1377。

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