肾功能及其他因素与跌倒的关系：欧洲老年人慢性肾脏病筛查研究（SCOPE）。
Kidney function and other factors and their association with falls : The screening for CKD among older people across Europe (SCOPE) study.
机构信息
Department of Internal Medicine-Geriatrics, Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
Department of Nursing, Recanati School for Community Health Professions at the faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel.
出版信息
BMC Geriatr. 2020 Oct 2;20(Suppl 1):320. doi: 10.1186/s12877-020-01698-2.
BACKGROUND
Reduced kidney function has become a major public health concern, especially among older people, as Chronic Kidney Disease (CKD) is associated with increased risk of end stage renal disease and mortality. Falls are a serious negative health outcome in older persons with one third of people aged 65 years experiencing a fall per year and increasing fall rates with increasing age. The impact of CKD on falls in older community-dwelling persons is not well investigated. Additionally, lower urinary tract symptoms (LUTS) may also increase the risk of falls. Therefore, our aim was to investigate the impact of CKD and LUTS on falls as well as on injurious falls.
METHODS
The SCOPE study is an observational, multinational, multicenter, prospective cohort study involving community-dwelling older persons aged 75 years and more recruited from August 2016 to March 2018 in seven European countries. The main outcomes of the present study were any falls and any injurious falls during the 12 months before enrolment. The cross-sectional association of estimated glomerular filtration rate (eGFR) and LUTS with study outcomes was investigated by logistic regression analysis adjusted for baseline characteristics of enrolled subjects.
RESULTS
Our series consisted of 2256 SCOPE participants (median age = 79.5 years, 55.7% female). Of them, 746 participants experienced a fall and 484 reported an injurious fall in the 12 months prior to baseline assessment. CKD was not significantly associated with falls (OR = 0.95, 95%CI = 0.79-1.14 for eGFR< 60; OR = 1.02, 95%CI = 0.81-1.28 for eGFR< 45; OR = 1.08, 95%CI = 0.74-1.57 for eGFR< 30) or injurious falls (OR = 0.91, 95%CI = 0.67-1.24 for eGFR< 60; OR = 0.93, 95%CI = 0.63-1.37 for eGFR< 45; OR = 1.19, 95%CI = 0.62-2.29 for eGFR< 30). LUTS were found significantly associated with both falls (OR = 1.56, 95%CI = 1.29-1.89) and injurious falls (OR = 1.58, 95%CI = 1.14-2.19), and such associations were confirmed in all multivariable models.
CONCLUSIONS
Cross-sectional data suggest that CKD may not be associated with history of falls or injurious falls, whereas LUTS is significantly associated with the outcomes.
TRIAL REGISTRATION
This study was registered on 25th February 2016 at clinicaltrials.gov ( NCT02691546 ).
背景
肾功能下降已成为一个主要的公共健康问题，尤其是在老年人中，因为慢性肾脏病（CKD）与终末期肾病和死亡率的风险增加有关。跌倒在老年人中是一个严重的负面健康后果，有三分之一的 65 岁以上的人每年都会跌倒，而且随着年龄的增长，跌倒的发生率也在增加。CKD 对老年人跌倒的影响尚未得到很好的研究。此外，下尿路症状（LUTS）也可能增加跌倒的风险。因此，我们的目的是研究 CKD 和 LUTS 对跌倒以及对伤害性跌倒的影响。
方法
SCOPE 研究是一项观察性、多国家、多中心、前瞻性队列研究，纳入了 2016 年 8 月至 2018 年 3 月来自 7 个欧洲国家的 75 岁及以上的社区居住老年人。本研究的主要结局是在登记前 12 个月内任何跌倒和任何伤害性跌倒。通过调整登记受试者的基线特征，对肾小球滤过率估计值（eGFR）和 LUTS 与研究结局的横断面关联进行逻辑回归分析。
结果
我们的研究系列包括 2256 名 SCOPE 参与者（中位数年龄为 79.5 岁，55.7%为女性）。其中，746 名参与者在基线评估前 12 个月内经历了跌倒，484 名参与者报告了伤害性跌倒。CKD 与跌倒（OR=0.95，95%CI=0.79-1.14，eGFR<60；OR=1.02，95%CI=0.81-1.28，eGFR<45；OR=1.08，95%CI=0.74-1.57，eGFR<30）或伤害性跌倒（OR=0.91，95%CI=0.67-1.24，eGFR<60；OR=0.93，95%CI=0.63-1.37，eGFR<45；OR=1.19，95%CI=0.62-2.29，eGFR<30）均无显著相关性。LUTS 与跌倒（OR=1.56，95%CI=1.29-1.89）和伤害性跌倒（OR=1.58，95%CI=1.14-2.19）均有显著相关性，所有多变量模型均证实了这一相关性。
结论
横断面数据表明，CKD 可能与跌倒或伤害性跌倒的病史无关，而 LUTS 与这些结果显著相关。
试验注册
该研究于 2016 年 2 月 25 日在 clinicaltrials.gov 注册（NCT02691546）。
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