Del Brutto O H, Mera R M, Peinado C D, Zambrano M, Sedler M J
Oscar H. Del Brutto, MD., Air Center 3542, PO Box 522970, Miami, Fl 33152-2970. Phone: +593-9997476984, email
J Frailty Aging. 2020;9(3):150-154. doi: 10.14283/jfa.2019.36.
Data supporting a link between frailty and risk of falls is mostly confined to individuals living in urban centers, where risk factors and lifestyles are different from that of rural settings.
To assess the association between frailty and risk of falls in older adults living in rural Ecuador.
Population-based cross-sectional study.
Community-dwellers aged ≥60 years living in a rural Ecuadorian village, in whom frail status and risk of falls were assessed.
Frailty was evaluated by the Edmonton Frailty Scale (EFS) and risk of falls by the Downton Fall Risk Index (DFRI). Multivariate models were fitted to evaluate whether frailty was associated with risk of falls (dependent variable), after adjusting for demographics, alcohol intake, cardiovascular risk factors, sleep quality, symptoms of depression, and history of an overt stroke. Correlation coefficients were constructed to assess confounders modifying this association.
A total of 324 participants (mean age: 70.5±8 years) were included. The mean EFS score was 4.4±2.5 points, with 180 (56%) participants classified as robust, 76 (23%) as pre-frail and 68 (21%) as frail. The DFRI was positive in 87 (27%) participants. In univariate analysis, the EFS score was higher among participants with a positive DFRI (p<0.001). The number of frail individuals was higher (p<0.001), while that of robust individuals was lower (p<0.001) among those with a positive DFRI. Adjusted logistic regression models showed no association between frailty and the DFRI. Correlation coefficients showed that age, high glucose levels, and history of an overt stroke tempered the association between frailty and the risk of falls found in univariate analyses.
Frailty is not independently associated with risk of falls in older adults living in a remote rural setting. Further studies are needed to assess the impact of frailty on the risk of falls in these populations.
支持衰弱与跌倒风险之间存在关联的数据大多局限于生活在城市中心的人群，而城市中的风险因素和生活方式与农村地区不同。
评估厄瓜多尔农村地区老年人衰弱与跌倒风险之间的关联。
基于人群的横断面研究。
居住在厄瓜多尔农村村庄的60岁及以上社区居民，对其衰弱状态和跌倒风险进行评估。
采用埃德蒙顿衰弱量表（EFS）评估衰弱情况，采用唐顿跌倒风险指数（DFRI）评估跌倒风险。在调整人口统计学、酒精摄入量、心血管危险因素、睡眠质量、抑郁症状和明显中风病史后，拟合多变量模型以评估衰弱是否与跌倒风险（因变量）相关。构建相关系数以评估影响这种关联的混杂因素。
共纳入324名参与者（平均年龄：70.5±8岁）。EFS平均得分为4.4±2.5分，其中180名（56%）参与者被归类为健康，76名（23%）为衰弱前期，68名（21%）为衰弱。87名（27%）参与者的DFRI为阳性。在单变量分析中，DFRI为阳性的参与者的EFS得分更高（p<0.001）。DFRI为阳性的人群中，衰弱个体数量更多（p<0.001），而健康个体数量更少（p<0.001）。调整后的逻辑回归模型显示衰弱与DFRI之间无关联。相关系数表明年龄、高血糖水平和明显中风病史减弱了单变量分析中发现的衰弱与跌倒风险之间的关联。
在偏远农村地区生活的老年人中，衰弱与跌倒风险无独立关联。需要进一步研究以评估衰弱对这些人群跌倒风险的影响。
