Marques Ana João, Rodrigues Ana M, Dias Sara, Canhão Helena, Branco Jaime, Vaz Carlos
Faculdade Medicina da Universidade do Porto (FMUP).
EpiDoC Unit, Centro de Estudos de Doenças Crónicas (CEDOC), NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), Lisboa, Portugal.
Acta Reumatol Port. 2019 Oct-Dec;44(4):288-295.
Falls are a major public health issue, given its prevalence and social impact. This study aimed to (1) characterize fallers in the adult Portuguese population as well as (2) identify if some chronic conditions are fall determinants.
Our data of 7403 adults (≥18 years) was retrieved from phase 1 survey of EpiReumaPt, a representative sample of adult Portuguese population. We analyzed sociodemographic variables and the presence of chronic diseases, which was evaluated by self-report. Anxiety/depression symptoms were assessed using The Hospital Anxiety and Depression Scale (HADS). Fall was defined by the presence of a self-report fall in the previous 12 months to the interview. Univariate and Multivariable logistic regression were used to assess fall determinants. Analyses were conducted in Stata v13.
The estimated prevalence of falls in the Portuguese population is 24,1%. Women are at 2.12 times higher risk of fall than man (95% CI 1.79 - 2.51) and there's also a progressive increasing association between age and falls, with people with 75+ years having greater odds of falling (OR = 1.86 95% CI 1.49 - 2.31). Different chronic health conditions were identified as major determinants of falls in the Portuguese population. Neurologic (OR = 1.64 95% CI 1.17 - 2.32) and rheumatic (OR = 1.44 95% CI 1.18 - 1.74) disease were significantly and independently associated with falls. Similar results were found for presence of anxiety (OR = 1.33 95% CI 1.04 - 1.71) or depression (OR = 1.61 95% CI 1.20 - 2.15) symptoms.
Our results show a perspective of the determinants of falls in the Portuguese population, allowing us to know that women and elders are at greater risk. We have showed that some chronic diseases are associated with falls, in particular musculoskeletal diseases and mental diseases. Implementing specific and adapted prevention strategies might reduce the number and complications of falls ultimately improving Portuguese overall health.
鉴于跌倒的普遍性及其社会影响，跌倒是一个重大的公共卫生问题。本研究旨在：（1）描述葡萄牙成年人群中的跌倒者特征；（2）确定某些慢性疾病是否为跌倒的决定因素。
我们从EpiReumaPt第一阶段调查中获取了7403名成年人（≥18岁）的数据，该调查是葡萄牙成年人群的代表性样本。我们分析了社会人口统计学变量和慢性疾病的存在情况，慢性疾病通过自我报告进行评估。使用医院焦虑抑郁量表（HADS）评估焦虑/抑郁症状。跌倒定义为在访谈前12个月内有自我报告的跌倒情况。采用单因素和多因素逻辑回归评估跌倒的决定因素。分析在Stata v13中进行。
葡萄牙人群中跌倒的估计患病率为24.1%。女性跌倒风险比男性高2.12倍（95%可信区间1.79 - 2.51），并且年龄与跌倒之间也存在逐渐增加的关联，75岁及以上人群跌倒的几率更高（比值比 = 1.86，95%可信区间1.49 - 2.31）。不同的慢性健康状况被确定为葡萄牙人群跌倒的主要决定因素。神经系统疾病（比值比 = 1.64，95%可信区间1.17 - 2.32）和风湿性疾病（比值比 = 1.44，95%可信区间1.18 - 1.74）与跌倒显著且独立相关。焦虑（比值比 = 1.33，95%可信区间1.04 - 1.71）或抑郁（比值比 = 1.61，95%可信区间1.20 - 2.15）症状的存在也有类似结果。
我们的结果展示了葡萄牙人群中跌倒决定因素的情况，使我们了解到女性和老年人风险更高。我们表明某些慢性疾病与跌倒有关，特别是肌肉骨骼疾病和精神疾病。实施特定且合适的预防策略可能会减少跌倒的数量和并发症，最终改善葡萄牙人的整体健康状况。
