Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore, Singapore.
Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
J Am Geriatr Soc. 2020 Nov;68(11):2602-2608. doi: 10.1111/jgs.16719. Epub 2020 Aug 17.
To determine the prevalence of fear of falling (FOF) and fear-related activity restriction (FAR) and their association with frailty, sarcopenia, gait speed and grip strength, cognitive impairment, depression, social isolation, self-perceived health, and vision.
Observational cross-sectional study.
Community.
A total of 493 community-dwelling older adults, 60 years and older.
FOF and FAR were assessed using validated single closed-ended questions. Questionnaire was administered to evaluate frailty (FRAIL scale - Fatigue, Resistance, Aerobic, Illness, and Loss of Weight), sarcopenia (SARC-F - lifting and carrying 10 pounds, walking across a room, transferring from bed/chair, climbing a flight of 10 stairs, and frequency of falls in the past 1 year), social isolation (six-item Lubben Social Network Scale), depression (Even Briefer Assessment Scale), cognition (Chinese Mini-Mental State Examination), and perceived general health and pain (The EuroQol-5 Dimension (EQ-5D)and EQ visual analogue scale (EQ VAS)) . Binary logistic regression was performed to determine the influence of sociodemographic, medical, functional, and cognitive variables on FOF with/without FAR.
Prevalence of FOF was 69.2%, and among them, 38.4% had FAR. Prevalence of FOF with or without FAR in those with sarcopenia was 93.3% and in prefrail/frail was 76.6%. FOF was significantly associated with prefrail/frail (odds ratio (OR) = 2.17; 95% confidence interval (CI) = 1.26-3.73), depression (OR = 4.90; 95% CI = 1.06-22.67), number of medications (OR = 1.28; 95% CI = 1.03-1.59), and female sex (OR = 3.54; 95% CI = 1.82-6.90). FOF + FAR was associated with depression (OR = 5.17; 95% CI = 1.84-14.54) and sarcopenia (OR = 8.13; 95% CI = 1.52-43.41).
FOF with/without FAR is highly prevalent among community-dwelling older adults, especially in those with sarcopenia, prefrailty, and frailty, with significant negative impact on function, quality of life, social network, and mental health. Further research is needed to investigate the value of population-level screening, causal relationship, and efficacy of comprehensive intervention strategies.
确定跌倒恐惧（FOF）和相关活动限制（FAR）的患病率，及其与虚弱、肌少症、步态速度和握力、认知障碍、抑郁、社会隔离、自我感知健康和视力的关系。
观察性横断面研究。
社区。
共纳入 493 名 60 岁及以上的社区居住老年人。
使用经过验证的单封闭式问题评估 FOF 和 FAR。问卷调查评估虚弱（FRAIL 量表-疲劳、抵抗、有氧运动、疾病和体重减轻）、肌少症（SARC-F-提起和携带 10 磅重物、穿过房间、从床/椅子转移、爬 10 级楼梯和过去 1 年的跌倒频率）、社会隔离（六项目卢本社会网络量表）、抑郁（Even Briefer 评估量表）、认知（中国简易精神状态检查表）和感知一般健康和疼痛（EuroQol-5 维度（EQ-5D）和 EQ 视觉模拟量表（EQ VAS））。进行二元逻辑回归分析以确定社会人口统计学、医学、功能和认知变量对 FOF 伴/不伴 FAR 的影响。
FOF 的患病率为 69.2%，其中 38.4%有 FAR。有肌少症的 FOF 伴或不伴 FAR 的患病率为 93.3%，而在虚弱前期/虚弱的患病率为 76.6%。FOF 与虚弱前期/虚弱（比值比（OR）=2.17；95%置信区间（CI）=1.26-3.73）、抑郁（OR=4.90；95%CI=1.06-22.67）、用药数量（OR=1.28；95%CI=1.03-1.59）和女性性别（OR=3.54；95%CI=1.82-6.90）显著相关。FOF+FAR 与抑郁（OR=5.17；95%CI=1.84-14.54）和肌少症（OR=8.13；95%CI=1.52-43.41）相关。
社区居住的老年人中 FOF 伴/不伴 FAR 的患病率较高，尤其是在肌少症、虚弱前期和虚弱的老年人中，对功能、生活质量、社交网络和心理健康有显著的负面影响。需要进一步研究以探讨人群水平筛查、因果关系和综合干预策略的疗效。
