Domergue H, Rodríguez-Mañas L, Laosa Zafra O, Hood K, Gasq D, Regueme S, Sinclair A J, Bourdel-Marchasson I
Hélène Domergue, Centre Hospitalier Universitaire de Bordeaux, France,
J Frailty Aging. 2020;9(1):44-50. doi: 10.14283/jfa.2019.27.
In older people, diabetes is associated with an increased risk of falls and frailty. The value of using posturography for evaluating the risk of falling is unclear. In theory, a time-scale analysis should increase the metrological properties of the posturography assessment.
This study aimed to determine which posturographic parameters can be used to identify fall-risk patients in a frail diabetic older population and to assess their interest in comparison to usual clinical trials for gait and balance.
This is a prospective observational cohort.
frail or pre-frail diabetic patients, in Bordeaux, France.
84 patients were included in the study (mean age 80.09 years, 64.5% of men).Criteria for inclusion were: age over 70 years, diabetes mellitus for over 2 years, and at least one of the Fried's frailty criteria.
Gait and balance assessments were undertaken at baseline: Static posturography, the timed up and go test, short physical performance battery, and (gait) walking speed. Raw data from posturography were used for wavelet analysis. Data on self reported new falls were collected prospectively during 6 months.
The posturography parameter most useful was area of 90% confidence ellipse of statokinesigram (COP90area): area under the ROC curve AUC = 0.617 (95% CI, 0.445-0.789) and OR=1.003 (95%CI 1.000-1.005) p =0.05. The optimum clinical test was the time to walk over 4m AUC=0.735 (95%CI, 0.587-0.882) and OR=1.42 (95%CI 1.08-1.87) p= 0.013.
Posturography has limited utility for assessment of falls risk in frail older people with diabetes. Gait and balance clinical assessments such as walking speed continue to retain their value.
在老年人中，糖尿病与跌倒和身体虚弱风险增加相关。使用姿势描记法评估跌倒风险的价值尚不清楚。理论上，时间尺度分析应可提高姿势描记法评估的计量特性。
本研究旨在确定哪些姿势描记参数可用于识别体弱糖尿病老年人群中的跌倒风险患者，并评估其与常规步态和平衡临床试验相比的价值。
这是一项前瞻性观察队列研究。
法国波尔多的体弱或体弱前期糖尿病患者。
84名患者纳入研究（平均年龄80.09岁，男性占64.5%）。纳入标准为：年龄超过70岁、糖尿病病程超过2年，以及至少符合一项弗里德虚弱标准。
在基线时进行步态和平衡评估：静态姿势描记法、计时起立行走测试、简短体能测试电池组以及（步态）步行速度。姿势描记法的原始数据用于小波分析。前瞻性收集6个月内自我报告的新跌倒数据。
最有用的姿势描记参数是静态运动图90%置信椭圆面积（COP90area）：ROC曲线下面积AUC = 0.617（95%CI，0.445 - 0.789），OR = 1.003（95%CI 1.000 - 1.005），p = 0.05。最佳临床测试是4米步行时间，AUC = 0.735（95%CI，0.587 - 0.882），OR = 1.42（95%CI 1.08 - 1.87），p = 0.013。
姿势描记法在评估体弱糖尿病老年人跌倒风险方面效用有限。步态和平衡临床评估如步行速度仍具有价值。
