Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
Exp Gerontol. 2021 Apr;146:111248. doi: 10.1016/j.exger.2021.111248. Epub 2021 Jan 21.
The development of cognitive impairment and Fear of Falling (FoF) are strongly linked, but prevalence of FoF is not known in patients with different types of dementia. This study aims to evaluate and compare the prevalence and severity of FoF in patients' with dementia with Lewy bodies (DLB), Alzheimer disease (AD), and non-dementia.
46 participants with DLB, 86 participants with AD and participants without dementia (controls), underwent Comprehensive Geriatric Assessment (CGA). The Falls Efficacy Scale-International (FES-I) was used to determine and classify FoF. An overall score on the FES-I of 16-19, 20-27 and ≥28, was accepted as low, moderate, and high concern about FoF, respectively.
Prevalence of high FoF was 86.9% in DLB, 36.0% in AD and 37.4% in controls. All CGA parameters were worse in the DLB and AD group than non-dementia group (p < 0.001). The prevalence of high FoF/FES-scores was significantly higher in the DLB group than in the AD and non-dementia group (p < 0.001), but was similar in AD and non-dementia groups (p > 0.05). The significant relationship between DLB and FoF was maintained when adjusted for age, CGA parameters, and orthostatic hypotension (OR: 2.55, CI: 1.03-6.25, p = 0.041 comparison to AD; OR: 4.79, CI: 2.10-10.92, p < 0.001 comparison to non-dementia).
Eight out of ten elderly patients with DLB have high FoF, which is much higher than those with AD and without dementia. Therefore, clinicians should be aware of FoF and its related consequences in the management of DLB in older adults.
认知障碍和跌倒恐惧（Fear of Falling，FoF）的发展密切相关，但不同类型痴呆患者 FoF 的患病率尚不清楚。本研究旨在评估和比较路易体痴呆（Dementia with Lewy bodies，DLB）、阿尔茨海默病（Alzheimer disease，AD）和非痴呆患者 FoF 的患病率和严重程度。
46 名 DLB 患者、86 名 AD 患者和无痴呆症的对照组参与者接受了全面老年评估（Comprehensive Geriatric Assessment，CGA）。使用跌倒效能量表-国际版（Falls Efficacy Scale-International，FES-I）来确定和分类 FoF。FES-I 总分为 16-19、20-27 和≥28 分分别被认为是 FoF 低度、中度和高度关注。
DLB 患者 FoF 高发生率为 86.9%，AD 患者为 36.0%，对照组为 37.4%。DLB 和 AD 组的所有 CGA 参数均差于非痴呆组（p<0.001）。DLB 组 FoF/FES 评分高的患病率明显高于 AD 和非痴呆组（p<0.001），但 AD 和非痴呆组之间无差异（p>0.05）。调整年龄、CGA 参数和体位性低血压后，DLB 与 FoF 之间仍存在显著相关性（与 AD 相比，OR：2.55，CI：1.03-6.25，p=0.041；与非痴呆相比，OR：4.79，CI：2.10-10.92，p<0.001）。
十分之八的老年 DLB 患者存在 FoF，远高于 AD 患者和无痴呆症患者。因此，临床医生在管理老年 DLB 时应注意 FoF 及其相关后果。
