Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan.
J Am Med Dir Assoc. 2019 Feb;20(2):195-200.e1. doi: 10.1016/j.jamda.2018.09.009. Epub 2018 Nov 5.
A discrepancy in self-reported and performance-based physical functioning levels is often observed among older adults. We investigated the association of discrepancy in self-reported and performance-based physical functioning levels with risk of future falls among community-dwelling older adults.
Prospective cohort study.
Two communities in Fukushima Prefecture, Japan.
1379 older adults who took part in the yearly health checkup in both 2009 and 2010.
The performance-based and self-reported physical functioning levels were evaluated by the Timed Up and Go test and the Short-Form 12 Health Survey (Japanese version) physical functioning subscale, respectively. We divided the participants into 4 groups based on the combinations of low or high performance-based and self-reported physical functioning groups, which were classified by age- and sex-specific reference values. The main outcome was the occurrence of any falls within the 1-year follow-up period, assessed using a self-reported questionnaire.
A total of 22% of the participants reported the occurrence of a fall during the follow-up period. In multivariable logistic regression analysis, the adjusted odds ratios of the high self-reported and low performance-based, low self-reported and high performance-based, and low self-reported and low performance-based physical functioning groups were 1.10 (95% confidence interval [CI], 0.67-1.82), 1.76 (95% CI, 1.17-2.66), and 1.80 (95% CI, 1.11-2.90), respectively, compared with the high self-reported and high performance-based physical functioning group.
Our findings suggest that the discrepancy as high performance-based but low self-reported physical functioning level is associated with an increased risk of future falls in older adults aged 65-89 years. Clinicians should carefully assess older adults whose subjective perception of their physical functioning capacity is lower than those in similar age and sex groups, even if their actual physical functioning appears to be objectively high.
在老年人中，常观察到自我报告和基于表现的身体功能水平之间存在差异。我们研究了社区居住的老年人中，自我报告和基于表现的身体功能水平之间的差异与未来跌倒风险之间的关联。
前瞻性队列研究。
日本福岛县的两个社区。
1379 名参加了 2009 年和 2010 年每年健康检查的老年人。
基于表现的和自我报告的身体功能水平分别通过计时起立行走测试和简短形式 12 健康调查（日本版）身体功能子量表进行评估。我们根据年龄和性别特异性参考值分类的低或高基于表现和自我报告的身体功能组的组合，将参与者分为 4 组。主要结局是在 1 年随访期间发生任何跌倒，使用自我报告的问卷进行评估。
在随访期间，共有 22%的参与者报告发生了跌倒。在多变量逻辑回归分析中，高自我报告和低基于表现、低自我报告和高基于表现以及低自我报告和低基于表现的身体功能组的调整后比值比分别为 1.10（95%置信区间 [CI]，0.67-1.82）、1.76（95%CI，1.17-2.66）和 1.80（95%CI，1.11-2.90），与高自我报告和高基于表现的身体功能组相比。
我们的研究结果表明，高基于表现但低自我报告的身体功能水平的差异与 65-89 岁老年人未来跌倒风险增加相关。即使实际身体功能似乎客观较高，临床医生也应仔细评估自我报告的身体功能能力低于同年龄和性别组的老年人。
