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分析居住在西班牙长期护理机构的老年人群体的跌倒风险因素:一项回顾性队列研究。

Analysis of Fall Risk Factors in an Aging Population Living in Long-Term Care Institutions in SPAIN: A Retrospective Cohort Study.

机构信息

Departament of Physiotherapy, DomusVi Remedios Center, Avda. Córdoba, 98, Aguilar de la Frontera, 14920 Córdoba, Spain.

Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, C/Avicena s/n, 41009 Seville, Spain.

出版信息

Int J Environ Res Public Health. 2020 Oct 3;17(19):7234. doi: 10.3390/ijerph17197234.

Abstract

Falls in the elderly are associated with morbidity and mortality. Research about fall risk factors in Spanish care facilities is scarce. This study aimed to assess the prevalence of falls among residents living in long-term care Spanish institutions and to identify fall risk factors in this population. A nationwide retrospective cohort study was conducted in 113 centers. Persons over 70 years old who were living in a residential setting for at least 1 year were included. Simple and multiple regression analyses were conducted to estimate the associations between the main clinical variables registered in the databases and the presence of falls. A total of 2849 subjects were analyzed (mean age 85.21 years). The period prevalence of fallers in the last 12 months was 45.3%, with a proportion of recurrent fallers of 51.7%. The presence of falls was associated with lower Tinetti Scale scores (OR = 1.597, 95% CI: 1.280, 1.991; OR = 1.362, 95% CI: 1.134, 1.635), severe or moderate cognitive impairment (OR= 1.992, 95% CI: 1.472, 2.695; OR = 1.507, 95% CI: 1.231, 1.845, respectively), and polypharmacy (OR = 1.291, 95% CI: 1.039, 1.604). Fall prevention interventions should focus on the prevention of balance and cognitive deterioration and the improvement of these functions when possible. It should also focus on a periodical medication history revision aiming to avoid inappropriate prescriptions.

摘要

老年人跌倒与发病率和死亡率有关。关于西班牙护理机构跌倒风险因素的研究很少。本研究旨在评估居住在长期护理西班牙机构的居民跌倒的发生率,并确定该人群的跌倒风险因素。在 113 个中心进行了一项全国性回顾性队列研究。纳入年龄超过 70 岁、至少在居住环境中生活 1 年的人。进行简单和多元回归分析,以估计数据库中主要临床变量与跌倒之间的关联。共分析了 2849 名受试者(平均年龄 85.21 岁)。过去 12 个月中,跌倒者的时期发生率为 45.3%,复发性跌倒者的比例为 51.7%。跌倒的发生与较低的 Tinetti 量表评分相关(OR = 1.597,95%CI:1.280,1.991;OR = 1.362,95%CI:1.134,1.635),严重或中度认知障碍(OR= 1.992,95%CI:1.472,2.695;OR = 1.507,95%CI:1.231,1.845),以及多药治疗(OR = 1.291,95%CI:1.039,1.604)。跌倒预防干预应侧重于预防平衡和认知恶化,并尽可能改善这些功能。还应定期审查用药史,以避免不适当的处方。

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