Department of Global Health Entrepreneurship, Division of Public Health, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo, 113-8519, Japan.
Faculty of Public Health, College of Medicine and Pharmacy, Hue University, Hue, Vietnam.
BMC Geriatr. 2020 Apr 16;20(1):141. doi: 10.1186/s12877-020-01533-8.
Fear of falling (FoF) in the elderly is one of the major public health concerns in this era of aging of the population. As there is limited evidence on how cognitive function may differ by social support level in relation to FoF among the elderly, this cross-sectional study aims to investigate the prevalence of FoF and the associations between cognitive impairment and FoF by the social support level, after adjustments for potential confounders.
Data from the "Health needs assessment of elderly in Thua Thien Hue Province, Vietnam in 2018" survey of 725 elderly aged 60 years or older were used for analysis. FoF was assessed using the Fall Efficacy Scale-International. High FoF was defined as a score above 28. The Multidimensional Scale of Perceived Social Support was used to measure the perception of support. Logistic regression analysis was performed to investigate the association between cognitive function and FoF by social support levels (p < 0.05).
The prevalence of high FoF among the elderly was 40.8%. Female gender, advanced age, a marital status of single or formerly married, living alone, history of injury, history of falls, chronic diseases (arthritis and/or hypertension), limitations of the IADL and BADL, visual difficulty and walking difficulty, low social support, and cognitive impairment were all significantly associated with a high FoF. After adjustments for the age, gender, marital status, history of falls and health-related factors, cognitive impairment remained significantly associated with a high FoF among the elderly with a low to moderate social support level (OR = 2.97, 95% CI 1.49-5.89), but not in those with a high social support level.
A high FoF was associated with impairment of cognitive function among the elderly who perceived themselves as having low or moderate support levels, even after adjustments for socio demographic and physical functional factors. However, this association was not observed among the elderly who perceived themselves as having high social support levels. Fall prevention programs for the elderly with various levels of social support should be carefully devised, keeping in mind the cognitive function levels of the target recipients.
在人口老龄化的时代，老年人跌倒恐惧（FoF）是主要的公共卫生问题之一。由于认知功能可能因社会支持水平而异，而关于老年人 FoF 的证据有限，因此本横断面研究旨在调查 FoF 的流行情况，并在调整潜在混杂因素后，根据社会支持水平，研究认知障碍与 FoF 之间的关系。
本研究使用了 2018 年越南顺化省老年人健康需求评估调查的数据，该调查纳入了 725 名 60 岁或以上的老年人。采用跌倒效能量表-国际版评估 FoF。高 FoF 定义为评分高于 28 分。多维感知社会支持量表用于评估支持感。Logistic 回归分析用于调查社会支持水平与认知功能和 FoF 之间的关系（p<0.05）。
老年人 FoF 的患病率为 40.8%。女性、高龄、未婚或离异、独居、有受伤史、有跌倒史、患有慢性疾病（关节炎和/或高血压）、IADL 和 BADL 受限、视力障碍和行走困难、社会支持低以及认知障碍均与 FoF 高显著相关。在调整年龄、性别、婚姻状况、跌倒史和与健康相关的因素后，认知障碍仍与社会支持水平低或中老年人 FoF 显著相关（OR=2.97，95%CI 1.49-5.89），但与社会支持水平高的老年人无关。
在感知到低或中社会支持水平的老年人中，认知功能障碍与 FoF 相关，即使在调整了社会人口和身体功能因素后也是如此。然而，在感知到高社会支持水平的老年人中，没有观察到这种相关性。应根据老年人的社会支持水平，精心设计针对各种水平社会支持的老年人跌倒预防计划，同时要考虑到目标受助人的认知功能水平。
