Department of Internal Medicine and Geriatrics, University Hospital of Montpellier, France; MUSE, Montpellier University, France; MACVIA France and Charité, Berlin, Germany; EA 2991, Euromov, Montpellier University, France.
Department of Medical Information, University Hospital of Montpellier, France.
Exp Gerontol. 2021 Jan;143:111154. doi: 10.1016/j.exger.2020.111154. Epub 2020 Nov 13.
To determine whether fatigue may be a risk factor for falling in older men and women, independent of other components of the frailty phenotype, fear of falling, and physical performance.
Among 986 women and 485 men visiting a health resort (mean age 72.3 and 72.7, respectively), subjects with at least one fall in the previous year were compared with non-fallers using a multivariate logistic regression analysis. Age, fatigue and fear of falling over the previous month were assessed by visual analogue scale (VAS), and the past 7 days of activity were assessed using the International Physical Activity Questionnaire. The following parameters were also assessed: weight loss in the past year, maximum grip strength measured with a hand dynamometer, time to perform the 5-chair stand and the up and go tests, time to walk 4 m, time held on one leg, feet together, as well as in the semi-tandem and tandem positions.
A feeling of fatigue (VAS score ≥ 5/10 in women or ≥4/10 in men), a fear of falling (VAS score ≥ 4/10 in women or ≥2 in men), and poor balance (time held in semi-tandem position < 10 s in women and time held on one leg < 6.5 s in men) were the 3 independent parameters distinguishing fallers from non-fallers.
The present study suggests the interest of adding a VAS score of fatigue to that of fear of falling and balance measurements for screening men and women aged 65 or older who are at risk of falls.
确定疲劳是否是老年人跌倒的一个风险因素，而与虚弱表型的其他成分、跌倒恐惧和身体表现无关。
在 986 名女性和 485 名男性前往健康度假村时（平均年龄分别为 72.3 和 72.7 岁），通过多变量逻辑回归分析比较了过去一年至少跌倒一次的受试者与非跌倒者。使用视觉模拟量表（VAS）评估过去一个月的年龄、疲劳和跌倒恐惧，使用国际体力活动问卷评估过去 7 天的活动情况。还评估了以下参数：过去一年体重减轻、用握力计测量的最大握力、完成 5 次椅子站立和起立行走测试的时间、行走 4 米的时间、单腿站立的时间，双脚并拢，以及半前后位和前后位。
感觉疲劳（女性 VAS 评分≥5/10 或男性 VAS 评分≥4/10）、跌倒恐惧（女性 VAS 评分≥4/10 或男性 VAS 评分≥2）和平衡差（女性半前后位保持时间<10s，男性单腿站立时间<6.5s）是区分跌倒者和非跌倒者的 3 个独立参数。
本研究表明，对于 65 岁或以上有跌倒风险的男性和女性，在筛选时，除了跌倒恐惧和平衡测量外，增加疲劳 VAS 评分可能会更有意义。
