Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
Stockholm Gerontology Research Center, Stockholm, Sweden.
J Am Geriatr Soc. 2019 Feb;67(2):246-253. doi: 10.1111/jgs.15657. Epub 2018 Nov 29.
To identify sex-specific associations between risk factors and injurious falls over the short (<4 years) and long (4-10 years) term.
Longitudinal cohort study between 2001 and 2011.
Swedish National Study on Aging and Care, Kungsholmen, Sweden.
Community-dwelling adults aged 60 and older (N = 3,112).
An injurious fall was defined as a fall that required inpatient or outpatient care. Information was collected on participant and exposure characteristics using structured interviews, clinical examinations, and physical function tests at baseline.
The multivariate model showed that, in the short term, living alone (hazard ratio (HR)=1.83, 95% confidence interval (CI)=1.13-2.96), dependency in instrumental activities of daily living (IADLs) (HR=2.59, 95% CI=1.73-3.87), and previous falls (HR=1.71, 95% CI=1.08-2.72) were independently associated with injurious falls in women. Low systolic blood pressure (HR=1.96, 95% CI=1.04-3.71), impaired chair stands (HR=3.00, 95% CI=1.52-5.93), and previous falls (HR=2.81, 95% CI=1.32-5.97) were associated with injurious falls in men. Long-term risk factors were underweight (HR=2.03, 95% CI=1.40-2.95), cognitive impairment (HR=1.49, 95% CI=1.08-2.06), fall-risk increasing drugs (HR=1.67, 95% CI=1.27-2.20 for ≥2 drugs), and IADL dependency (HR=1.58, 95% CI=1.32-5.97) for women and smoking (HR=1.71, 95% CI=1.03-2.84), heart disease (HR=2.20, 95% CI=1.5-3.24), impaired balance (HR=1.68, 95% CI=1.08-2.62), and a previous fall (HR=3.61, 95% CI=1.98-6.61) for men.
Men and women have different fall risk profiles, and these differences should be considered when developing preventive strategies. Some risk factors were more strongly predictive of injurious falls over shorter than longer periods and vice versa, suggesting that it may be possible to identify older men and women at short- and long-term risk of injurious falls. J Am Geriatr Soc 67:246-253, 2019.
确定短期（<4 年）和长期（4-10 年）内风险因素与伤害性跌倒之间的性别特异性关联。
2001 年至 2011 年期间的纵向队列研究。
瑞典 Kungsholmen 的瑞典老龄化和护理国家研究。
年龄在 60 岁及以上的社区居住成年人（N=3112）。
伤害性跌倒定义为需要住院或门诊治疗的跌倒。使用结构化访谈、临床检查和身体功能测试在基线时收集参与者和暴露特征的信息。
多变量模型显示，在短期内，独居（危险比（HR）=1.83，95%置信区间（CI）=1.13-2.96）、工具性日常生活活动（IADLs）依赖（HR=2.59，95% CI=1.73-3.87）和既往跌倒（HR=1.71，95% CI=1.08-2.72）与女性的伤害性跌倒独立相关。低收缩压（HR=1.96，95% CI=1.04-3.71）、椅子站立障碍（HR=3.00，95% CI=1.52-5.93）和既往跌倒（HR=2.81，95% CI=1.32-5.97）与男性的伤害性跌倒相关。长期风险因素包括体重不足（HR=2.03，95% CI=1.40-2.95）、认知障碍（HR=1.49，95% CI=1.08-2.06）、增加跌倒风险的药物（HR=1.67，95% CI=1.27-2.20 用于≥2 种药物）和 IADL 依赖（HR=1.58，95% CI=1.32-5.97），女性和吸烟（HR=1.71，95% CI=1.03-2.84）、心脏病（HR=2.20，95% CI=1.5-3.24）、平衡障碍（HR=1.68，95% CI=1.08-2.62）和既往跌倒（HR=3.61，95% CI=1.98-6.61）与男性相关。
男性和女性具有不同的跌倒风险特征，在制定预防策略时应考虑这些差异。一些风险因素对伤害性跌倒的预测作用在较短和较长时间内存在差异，反之亦然，这表明有可能识别出短期和长期有伤害性跌倒风险的老年男性和女性。美国老年医学会 67:246-253, 2019.
