老年人自我报告视力障碍与跌倒及跌倒相关结局的患病率。
Prevalence of Falls and Fall-Related Outcomes in Older Adults with Self-Reported Vision Impairment.
机构信息
Center for Eye Policy and Innovation, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan.
Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan.
出版信息
J Am Geriatr Soc. 2019 Feb;67(2):239-245. doi: 10.1111/jgs.15628. Epub 2018 Nov 13.
OBJECTIVES
To determine the prevalence of falls, fear of falling (FoF), and activity limitation due to FoF in a nationally representative study of older adults with self-reported vision impairment (VI).
DESIGN
Cross-sectional analysis of panel survey data.
SETTING
National Health and Aging Trends Study, a nationally representative survey administered annually from 2011 to 2016 to U.S. Medicare beneficiaries aged 65 and older.
PARTICIPANTS
Respondents (N=11,558) who contributed 36,229 participant observations.
MEASUREMENTS
We performed logistic regression to calculate the unadjusted and adjusted prevalence of self-reported history of more than 1 fall in the past year, any fall in the past month, FoF, and activity limitation due to FoF in participants with and without self-reported VI.
RESULTS
The weighted proportion of participants reporting VI was 8.6% (95% confidence interval (CI)=8.0-9.2%). The unadjusted prevalence of more than 1 fall in the past year was 27.6% (95% CI=25.5-29.7%) in participants with self-reported VI and 13.2% (95% CI=12.7-13.7%) in those without self-reported VI. In respondents with self-reported VI, the prevalence of FoF was 48.3% (95% CI=46.1-50.6%) and of FoF limiting activity was 50.8% (95%CI 47.3-54.2%), and in those without self-reported VI, the prevalence of FoF was 26.7% (95% CI=25.9-27.5%) and of FoF limiting activity was 33.9% (95% CI=32.4-35.4%). The prevalence of all fall and fall-related outcomes remained significantly higher among those with self-reported VI after adjusting for sociodemographics and potential confounders.
CONCLUSION
The prevalence of falls, FoF, and activity limitation due to FoF is high in older adults with self-reported VI. This is the first study to provide nationally representative data on the prevalence of fall-related outcomes in older Americans with self-reported VI. These findings demonstrate the need to treat avoidable VI and to develop interventions to prevent falls and fall-related outcomes in this population. J Am Geriatr Soc 67:239-245, 2019.
目的
在一项针对有自我报告视力障碍（VI）的老年人的全国性代表性研究中，确定报告有跌倒、跌倒恐惧（FoF）和因 FoF 而活动受限的发生率。
设计
横断面分析面板调查数据。
地点
国家健康老龄化趋势研究，这是一项全国性的代表性调查，从 2011 年到 2016 年，每年对美国年满 65 岁及以上的医疗保险受益人进行调查。
参与者
对报告有超过 1 次过去 1 年跌倒史、过去 1 个月内跌倒史、FoF 以及因 FoF 而活动受限的受访者（N=11558）进行了 36229 次参与者观察。
测量方法
我们进行了逻辑回归分析，以计算报告有 VI 的参与者和未报告 VI 的参与者中，过去 1 年报告有超过 1 次跌倒史、过去 1 个月内跌倒史、FoF 和因 FoF 而活动受限的未调整和调整后的发生率。
结果
报告有 VI 的参与者的加权比例为 8.6%（95%置信区间[CI]=8.0-9.2%）。报告有 VI 的参与者中，过去 1 年报告有超过 1 次跌倒史的未调整发生率为 27.6%（95%CI=25.5-29.7%），而未报告有 VI 的参与者中为 13.2%（95%CI=12.7-13.7%）。在报告有 VI 的受访者中，FoF 的发生率为 48.3%（95%CI=46.1-50.6%），因 FoF 而活动受限的发生率为 50.8%（95%CI 47.3-54.2%），而在未报告有 VI 的受访者中，FoF 的发生率为 26.7%（95%CI=25.9-27.5%），因 FoF 而活动受限的发生率为 33.9%（95%CI=32.4-35.4%）。在调整了社会人口统计学和潜在混杂因素后，报告有 VI 的参与者的所有跌倒和与跌倒相关的结局发生率仍然显著较高。
结论
在有自我报告 VI 的老年人中，跌倒、FoF 和因 FoF 而活动受限的发生率较高。这是第一项提供关于有自我报告 VI 的美国老年人与跌倒相关结局发生率的全国代表性数据的研究。这些发现表明，需要治疗可避免的 VI，并制定干预措施，以预防这一人群的跌倒和与跌倒相关的结局。美国老年学会杂志 67:239-245, 2019。
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