Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
J Am Med Dir Assoc. 2019 Sep;20(9):1163-1168.e3. doi: 10.1016/j.jamda.2019.02.023. Epub 2019 Apr 4.
The aim of this study was to create a screening tool to predict first-time injurious falls in community-living older men and women.
Longitudinal cohort study between 2001 and 2009.
The Swedish National Study on Aging and Care in Kungsholmen (SNAC-K), Sweden.
Community-living older adults (n = 2808; 1750 women and 1058 men) aged ≥60 years (mean age 73, standard deviation 10.3).
The outcome was injurious falls within 5 years from baseline survey. Data on the risk factors for falls were collected through interviews, clinical examinations, and tests at baseline. Several previously established fall risk factors were identified for the development of the screening tool. The tool was formulated based on the β coefficients from sex-specific multivariate Cox proportional hazards models. The discriminative power was assessed using Harrell C statistic.
Old age, living alone, being dependent in instrumental activities of daily living, and impaired balance were the factors included in the final score of the First Injurious Fall (FIF) screening tool. The predictive values (Harrell C statistic) for the scores were 0.75 for women and 0.77 for men. The sensitivity and specificity at the Youden cut-off points were 0.69 and 0.70 for women, and 0.72 and 0.71 for men.
The FIF screening tool for first injurious fall in older persons consists of 3 questions and a physical test (5-second 1-leg standing balance with eyes open). Quick and easy to administer, it could be ideal for use in primary care or public health to identify older men and women at high fall risk, who may benefit from primary preventive interventions.
本研究旨在创建一种筛查工具，以预测社区居住的老年男女首次受伤性跌倒。
2001 年至 2009 年的纵向队列研究。
瑞典斯德哥尔摩 Kungsholmen 的全国老龄化和护理研究（SNAC-K）。
社区居住的老年人（n=2808；1750 名女性和 1058 名男性）年龄≥60 岁（平均年龄 73 岁，标准差 10.3 岁）。
结局为从基线调查起 5 年内受伤性跌倒。通过访谈、临床检查和基线测试收集跌倒风险因素的数据。为制定筛查工具确定了几个先前建立的跌倒风险因素。该工具是根据性别特异性多变量 Cox 比例风险模型的β系数制定的。使用 Harrell C 统计量评估区分能力。
年龄较大、独居、日常生活活动工具性依赖以及平衡受损是最终纳入首次受伤性跌倒（FIF）筛查工具的评分的因素。评分的预测值（Harrell C 统计量）女性为 0.75，男性为 0.77。在 Youden 截断点的敏感性和特异性为女性 0.69 和 0.70，男性 0.72 和 0.71。
适用于识别高跌倒风险的老年男女的首次受伤性跌倒的 FIF 筛查工具包括 3 个问题和一个身体测试（睁眼 5 秒单腿站立平衡）。操作简便，非常适合在初级保健或公共卫生中使用，以识别可能受益于初级预防干预的高跌倒风险的老年男女。
