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老年人动脉僵硬度、衰弱与跌倒相关损伤之间的关联

Association Between Arterial Stiffness, Frailty and Fall-Related Injuries in Older Adults.

作者信息

Turusheva Anna, Frolova Elena, Kotovskaya Yulia, Petrosyan Yurij, Dumbadze Rauli

机构信息

The North-Western State Medical University Named After I.I. Mechnikov, St. Petersburg, Russia.

Russian Clinical and Research Center of Gerontology, Pirogov Russian National Research Medical University, Moscow, Russia.

出版信息

Vasc Health Risk Manag. 2020 Jul 20;16:307-316. doi: 10.2147/VHRM.S251900. eCollection 2020.

Abstract

PURPOSE

This study was conducted to investigate the relationships between arterial stiffness, frailty and fall-related injuries among community-dwelling older adults.

MATERIALS AND METHODS

A cross-sectional study of a random sample of older adults aged 60 years and older was conducted. Main study parameters: arterial stiffness was measured by the determining the cardio-ankle vascular index (CAVI); Frailty status was defined using a 7-item frailty screening scale, developed in Russia. This questionnaire included question about falls and fall-related injuries. Orthostatic test and anthropometric tests were done. Medical history (comorbidity, medications), the Osteoporosis Self-assessment Tool (OST), nutritional, physical, cognitive and functional status were evaluated.

RESULTS

The study population included 163 people aged 60-89 years. The average predicted value of CAVI in women aged 60-69 was 9.13 ± 0.13, in men, 9.49 ± 0.05; in women aged 70-79, it was 9.49 ± 0.16, in men, 9.73 ±0.11; in women aged 80 and older it was 10.04 ±0.18, in men, 10.24 ±0.10 units. The CAVI above the predicted value was associated with fall-related injuries even after adjustment for age, sex, use of β-blockers (BBs), history of stroke, and region of residence with the odds ratio 3.52 (95% CI: 1.03 -12.04).

CONCLUSION

Our study revealed an independent association between arterial stiffness and fall-related injuries in older adults over 60 years. The findings suggest that clinicians, especially geriatricians, should pay attention to arterial stiffness of patients with fall-related injuries. Similarly, the patients with CAVI above age-predicted value should be evaluated for risk of falls for prevention of fall-related injuries.

摘要

目的

本研究旨在调查社区居住的老年人动脉僵硬度、衰弱与跌倒相关损伤之间的关系。

材料与方法

对60岁及以上老年人的随机样本进行横断面研究。主要研究参数:通过测定心踝血管指数(CAVI)来测量动脉僵硬度;衰弱状态使用俄罗斯开发的7项衰弱筛查量表进行定义。该问卷包括有关跌倒和跌倒相关损伤的问题。进行了直立试验和人体测量测试。评估了病史(合并症、用药情况)、骨质疏松自我评估工具(OST)、营养、身体、认知和功能状态。

结果

研究人群包括163名60 - 89岁的人。60 - 69岁女性的CAVI平均预测值为9.13±0.13,男性为9.49±0.05;70 - 79岁女性为9.49±0.16,男性为9.73±0.11;80岁及以上女性为10.04±0.18,男性为10.24±0.10单位。即使在调整年龄、性别、β受体阻滞剂(BBs)使用情况、中风病史和居住地区后,高于预测值的CAVI仍与跌倒相关损伤相关,比值比为3.52(95%置信区间:1.03 - 12.04)。

结论

我们的研究揭示了60岁以上老年人动脉僵硬度与跌倒相关损伤之间的独立关联。研究结果表明,临床医生,尤其是老年病医生,应关注跌倒相关损伤患者的动脉僵硬度。同样,CAVI高于年龄预测值的患者应评估跌倒风险,以预防跌倒相关损伤。

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