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芬兰老年人样本中慢性病与跌倒的关联。

Association between chronic diseases and falls among a sample of older people in Finland.

机构信息

VTT Technical Research Centre of Finland Ltd. Kaitoväylä 1, P.O.Box 1100, FI-90571, Oulu, Finland.

Center for Life Course Health Research, University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland.

出版信息

BMC Geriatr. 2020 Jun 26;20(1):225. doi: 10.1186/s12877-020-01621-9.

Abstract

BACKGROUND

Falls are a major problem for older people and recurrent fallers are especially prone to severe consequences due to falls. This study investigated the association between chronic conditions and falls.

METHODS

Responses from 872 older persons (age 65-98) to a health questionnaire were used in the analyses. Characteristics and disease prevalence between recurrent fallers, one-time fallers and non-fallers were compared. A hierarchical clustering method was applied to find combinations of chronic conditions that were associated with recent recurrent falling.

RESULTS

The results showed that recurrent fallers had a higher number of diseases (median 4, interquartile range, IQR = 2.0-5.0) compared to non-fallers (median 2, IQR = 1.0-3.0). Eight clusters were formed based on the data. The participants in the low chronic disease cluster were younger, more physically active, not frail, and had fewer geriatric conditions. Multiple chronic disease cluster participants were older, less physically active, overweight (body mass index, BMI > 30), at risk of malnutrition, and had more geriatric conditions. Significantly increased risk of recurrent falls relative to the low chronic cluster was found for respondents in the osteoporosis cluster and multiple chronic disease cluster (OR = 5.65, 95% confidence interval CI: 1.23-25.85, p = 0.026, and OR = 13.42, 95% CI: 2.47-72.96, p = 0.002, respectively). None of the clusters were associated with increased risk of one-time falling.

CONCLUSIONS

The results implicate that the number of chronic diseases is related with risk of recurrent falling. Furthermore, the results implicate the potential of identifying certain combinations of chronic diseases that increase fall risk by analyzing health record data, although further studies are needed with a larger population sample.

摘要

背景

跌倒对老年人来说是一个主要问题,而复发性跌倒者尤其容易因跌倒而遭受严重后果。本研究调查了慢性疾病与跌倒之间的关系。

方法

对 872 名(年龄 65-98 岁)老年人健康问卷的回答进行了分析。比较了复发性跌倒者、一次性跌倒者和非跌倒者的特征和疾病患病率。应用层次聚类方法寻找与近期复发性跌倒相关的慢性疾病组合。

结果

结果表明,复发性跌倒者的疾病数量(中位数 4,四分位距 IQR=2.0-5.0)高于非跌倒者(中位数 2,IQR=1.0-3.0)。根据数据形成了 8 个聚类。低慢性疾病聚类的参与者更年轻、更活跃、不过度肥胖(身体质量指数 BMI>30)、营养风险较低,且有较少的老年疾病。多慢性疾病聚类的参与者年龄较大、体力活动较少、超重(BMI>30)、有营养风险、且有更多的老年疾病。与低慢性疾病聚类相比,骨质疏松症聚类和多慢性疾病聚类的参与者复发性跌倒的风险显著增加(OR=5.65,95%置信区间 CI:1.23-25.85,p=0.026,和 OR=13.42,95%置信区间 CI:2.47-72.96,p=0.002)。没有一个聚类与一次性跌倒风险增加相关。

结论

结果表明慢性疾病的数量与复发性跌倒的风险有关。此外,通过分析健康记录数据,结果提示识别某些增加跌倒风险的慢性疾病组合的潜力,尽管需要进一步研究,纳入更大的人群样本。

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