Department of Physiotherapy, OsloMet - Oslo Metropolitan University, PO Box 4 St. Olavs plass, 0130, Oslo, Norway.
School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.
BMC Geriatr. 2018 Oct 22;18(1):253. doi: 10.1186/s12877-018-0945-6.
Falls and injuries in older adults have significant consequences and costs, both personal and to society. Although having a high incidence of falls, high prevalence of fear of falling and a lower quality of life, older adults receiving home care are underrepresented in research on older fallers. The objective of this study is to determine the associations between health-related quality of life (HRQOL), fear of falling and physical function in older fallers receiving home care.
This study employed cross-sectional data from baseline measurements of a randomised controlled trial. 155 participants, aged 67+, with at least one fall in the previous year, from six Norwegian municipalities were included. Data on HRQOL (SF-36), physical function and fear of falling (FES-I) were collected in addition to demographical and other relevant background information. A multivariate regression model was applied.
A higher score on FES-I, denoting increased fear of falling, was significantly associated with a lower score on almost all subscales of SF-36, denoting reduced HRQOL. Higher age was significantly associated with higher scores on physical function, general health, mental health and the mental component summary. This analysis adjusted for sex, education, living alone, being at risk of or malnourished, physical function like balance and walking speed, cognition and number of falls.
Fear of falling is important for HRQOL in older fallers receiving home care. This association is independent of physical measures. Better physical function is significantly associated with higher physical HRQOL. Future research should address interventions that reduce fear of falling and increase HRQOL in this vulnerable population.
ClinicalTrials.gov. NCT02374307 . First registration, 16 February 2015. First enrolment of participants, February 2016.
老年人跌倒和受伤会产生重大的个人和社会后果及成本。尽管老年人跌倒发生率高、对跌倒的恐惧普遍存在且生活质量较低，但接受家庭护理的老年人在老年人跌倒者的研究中代表性不足。本研究旨在确定接受家庭护理的老年跌倒者的健康相关生活质量（HRQOL）、对跌倒的恐惧和身体功能之间的关联。
本研究采用了一项随机对照试验基线测量的横断面数据。共有来自挪威六个城市的 155 名年龄在 67 岁以上、过去一年至少跌倒过一次的参与者纳入研究。除了人口统计学和其他相关背景信息外，还收集了 HRQOL（SF-36）、身体功能和对跌倒的恐惧（FES-I）的数据。应用了多变量回归模型。
FES-I 得分较高，表明对跌倒的恐惧增加，与 SF-36 的几乎所有子量表得分较低显著相关，表明 HRQOL 降低。年龄较大与身体功能、一般健康、心理健康和心理成分综合得分较高显著相关。该分析调整了性别、教育程度、独居、有风险或营养不良、身体功能（如平衡和行走速度）、认知和跌倒次数。
对跌倒的恐惧是接受家庭护理的老年跌倒者 HRQOL 的重要因素。这种关联独立于身体测量。更好的身体功能与更高的身体 HRQOL 显著相关。未来的研究应针对这一脆弱人群的减少对跌倒的恐惧和提高 HRQOL 的干预措施。
ClinicalTrials.gov。NCT02374307。首次注册，2015 年 2 月 16 日。首次纳入参与者，2016 年 2 月。
