Global Brain Health Institute, Trinity College Institute of Neuroscience, Trinity College Dublin, Lloyd Building, Dublin 2, Ireland.
Department of Sport and Exercise Sciences, Faculty of Science and Engineering, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, UK.
Osteoporos Int. 2019 Oct;30(10):2099-2117. doi: 10.1007/s00198-019-05034-2. Epub 2019 Jun 15.
We identified demographic, health and lifestyle factors associated with falls in adults aged 50-64 years from Australia, The Netherlands, Great Britain and Ireland. Nearly all factors were associated with falls, but there were differences between countries and between men and women. Existing falls prevention programs may also benefit middle-aged adults.
Between ages 40-44 and 60-64 years, the annual prevalence of falls triples suggesting that middle age may be a critical life stage for preventive interventions. We aimed to identify demographic, health and lifestyle factors associated with falls in adults aged 50-64 years.
Harmonised data were used from four population-based cohort studies based in Australia (Australian Longitudinal Study on Women's Health, n = 10,641, 51-58 years in 2004), Ireland (The Irish Longitudinal Study on Ageing, n = 4663, 40-64 years in 2010), the Netherlands (Longitudinal Ageing Study Amsterdam, n = 862, 55-64 years in 2012-13) and Great Britain (MRC National Survey of Health and Development, n = 2987, 53 years in 1999). Cross-sectional and prospective associations of 42 potential risk factors with self-reported falls in the past year were examined separately by cohort and gender using logistic regression. In the absence of differences between cohorts, estimates were pooled using meta-analysis.
In cross-sectional models, nearly all risk factors were associated with fall risk in at least one cohort. Poor mobility (pooled OR = 1.71, CI = 1.34-2.07) and urinary incontinence (OR range = 1.53-2.09) were consistently associated with falls in all cohorts. Findings from prospective models were consistent. Statistically significant interactions with cohort and sex were found for some of the risk factors.
Risk factors known to be associated with falls in older adults were also associated with falls in middle age. Compared with findings from previous studies of older adults, there is a suggestion that specific risk factors, for example musculoskeletal conditions, may be more important in middle age. These findings suggest that available preventive interventions for falls in older adults may also benefit middle-aged adults, but tailoring by age, sex and country is required.
我们确定了与澳大利亚、荷兰、英国和爱尔兰 50-64 岁成年人跌倒相关的人口统计学、健康和生活方式因素。几乎所有因素都与跌倒有关，但国家之间以及男女之间存在差异。现有的跌倒预防计划可能也有益于中年成年人。
在 40-44 岁和 60-64 岁之间，每年跌倒的患病率增加了两倍，这表明中年可能是预防干预的关键生活阶段。我们旨在确定与 50-64 岁成年人跌倒相关的人口统计学、健康和生活方式因素。
使用来自澳大利亚（澳大利亚妇女健康纵向研究，n=10641，2004 年为 51-58 岁）、爱尔兰（爱尔兰老龄化纵向研究，n=4663，2010 年为 40-64 岁）、荷兰（阿姆斯特丹纵向老龄化研究，n=862，2012-13 年为 55-64 岁）和英国（MRC 国家健康与发展调查，n=2987，1999 年为 53 岁）的四项基于人群的队列研究的协调数据。使用逻辑回归分别按队列和性别检查 42 个潜在风险因素与过去一年自我报告跌倒的横断面和前瞻性关联。在没有队列之间差异的情况下，使用荟萃分析汇总估计值。
在横断面模型中，几乎所有的危险因素都与至少一个队列的跌倒风险相关。行动不便（汇总 OR=1.71，95%CI=1.34-2.07）和尿失禁（OR 范围=1.53-2.09）在所有队列中始终与跌倒相关。前瞻性模型的结果一致。一些危险因素与队列和性别存在统计学显著的相互作用。
与老年成年人跌倒相关的危险因素也与中年成年人跌倒相关。与之前对老年人跌倒的研究结果相比，有迹象表明，某些特定的危险因素，例如肌肉骨骼疾病，在中年时期可能更为重要。这些发现表明，现有的针对老年人跌倒的预防干预措施也可能有益于中年成年人，但需要根据年龄、性别和国家进行调整。
