社会网络对老年人伤害性跌倒的风险和后果的影响。
Impact of Social Network on the Risk and Consequences of Injurious Falls in Older Adults.
机构信息
Geriatrics Division, Department of Medicine (DIMED), University of Padova, Padova, Italy.
Department of Neurobiology, Care Sciences and Society, Aging Research Center (ARC), Karolinska Institutet and Stockholm University, Stockholm, Sweden.
出版信息
J Am Geriatr Soc. 2019 Sep;67(9):1851-1858. doi: 10.1111/jgs.16018. Epub 2019 Jun 26.
OBJECTIVES
A smaller social network is associated with worse health-related outcomes in older people. We examined the impact of social connections and social support on the risk of injurious fall and on fall-related functional decline and mortality.
DESIGN
Prospective study with 6-year follow-up.
SETTING
Community.
PARTICIPANTS
A total of 2630 participants (aged ≥60 years) from the Swedish National Study on Aging and Care in Kungsholmen.
MEASUREMENTS
Social connections (social network size and contact frequency) and social support (social resource perception and satisfaction) were assessed through validated questionnaires. Data on injurious falls (falls requiring inpatient or outpatient care) and mortality came from official registers. We defined injurious falls as severe if they caused fracture and/or intracranial injury and as multiple if two or more occurred during the 6-year follow-up. Functional decline was defined as the loss of ability to perform one or more activities of daily living during the follow-up.
RESULTS
During the follow-up, 322 participants experienced injurious falls. After adjusting for potential confounders, the hazard ratio of injurious falls was 1.7 (95% confidence interval [CI] = 1.1-2.4) for people with poor social connections and 1.5 (95% CI = 1.1-2.1) for people with moderate social connections (reference: rich social connections). Social support was not associated with fall risk. The odds of functional decline among those with severe/multiple falls and (1) poor social connections (odds ratio [OR] = 5.2 [95% CI = 2.1-12.9]) or (2) poor social support (OR = 4.5 [95% CI = 1.7-12.0]) was up to twice as high as among those with severe/multiple falls and (3) rich social connections (OR = 2.5 [95% CI = .9-6.6]) or (4) rich social support (OR = 2.7 [95% CI = 1.2-6.3]). Similar but more attenuated results emerged for mortality.
CONCLUSIONS
Social network may influence fall risk and fall-related functional decline and mortality. J Am Geriatr Soc 67:1851-1858, 2019.
目的
较小的社交网络与老年人较差的健康相关结果有关。我们研究了社会联系和社会支持对伤害性跌倒风险以及与跌倒相关的功能下降和死亡率的影响。
设计
前瞻性研究，随访 6 年。
地点
社区。
参与者
来自瑞典 Kungsholmen 老龄化和护理全国研究的 2630 名参与者（年龄≥60 岁）。
测量
社交联系（社交网络规模和接触频率）和社会支持（社会资源感知和满意度）通过经过验证的问卷进行评估。伤害性跌倒（需要住院或门诊治疗的跌倒）和死亡率的数据来自官方登记处。我们将严重伤害性跌倒定义为导致骨折和/或颅内损伤的跌倒，如果在 6 年随访期间发生两次或两次以上跌倒，则定义为多发性跌倒。功能下降定义为在随访期间丧失一项或多项日常生活活动能力。
结果
在随访期间，322 名参与者经历了伤害性跌倒。在调整了潜在混杂因素后，社交联系较差的人发生伤害性跌倒的风险比为 1.7（95%置信区间[CI] = 1.1-2.4），社交联系适中的人发生伤害性跌倒的风险比为 1.5（95% CI = 1.1-2.1）（参考：社交联系丰富）。社会支持与跌倒风险无关。严重/多发性跌倒患者中功能下降的几率（1）社交联系较差（比值比[OR] = 5.2 [95% CI = 2.1-12.9]）或（2）社交支持较差（OR = 4.5 [95% CI = 1.7-12.0]）与严重/多发性跌倒患者（3）社交联系丰富（OR = 2.5 [95% CI =.9-6.6]）或（4）社交支持丰富（OR = 2.7 [95% CI = 1.2-6.3]）相比高达两倍。死亡率也出现了类似但更减弱的结果。
结论
社交网络可能会影响跌倒风险以及与跌倒相关的功能下降和死亡率。美国老年学会杂志 67:1851-1858,2019。
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