Khalatbari-Soltani Saman, Stanaway Fiona, Sherrington Cathie, Blyth Fiona M, Naganathan Vasi, Handelsman David J, Seibel Markus J, Waite Louise M, Le Couteur David G, Cumming Robert G
The University of Sydney School of Public Health, Faculty of Medicine and Health, New South Wales, Australia.
ARC Centre of Excellence in Population Aging Research (CEPAR), University of Sydney, Australia.
J Gerontol A Biol Sci Med Sci. 2021 Sep 13;76(10):1821-1828. doi: 10.1093/gerona/glab038.
Socioeconomic status (SES) has been suggested as a risk factor for falls but the few prospective studies to test this have had mixed results. We evaluated the prospective association between SES and falls in the Concord Health and Ageing in Men Project (CHAMP).
CHAMP is a population-based prospective cohort study of men aged ≥70 years in Sydney, Australia. Incident falls were ascertained by triannual telephone calls for up to 4 years. SES was assessed with 4 indicators (education, occupation, source of income, home ownership) and cumulative SES score. We tested for interaction between SES indicators and country of birth and conducted stratified analyses.
We evaluated 1624 men (mean age: 77.3 ± 5.4 years). During a mean ± SD follow-up of 42.6 ± 8.7 months, 766 (47%) participants reported ≥1 incident falls. In nonstratified analyses, there were no associations between SES indicators and falls. In stratified analyses, falls rates were higher among Australian-born men with less formal education (incidence rate ratio [IRR] 1.66, 95% confidence interval [CI] 1.16-2.37, compared with those with more education) and those with low occupational position (1.45; 1.09-1.93). However, among men born in non-main English-speaking countries the rate of falls was lower among those with low educational level and no associations were evident for occupational position.
Lower educational level and occupational position predicted a higher falls rate in Australian-born men; the opposite relationship was evident for educational level among migrants born in non-main English-speaking countries. Further studies should test these relationships in different populations and settings and evaluate targeted interventions.
社会经济地位（SES）被认为是跌倒的一个风险因素，但少数检验此观点的前瞻性研究结果不一。我们在康科德男性健康与老龄化项目（CHAMP）中评估了SES与跌倒之间的前瞻性关联。
CHAMP是一项基于人群的前瞻性队列研究，研究对象为澳大利亚悉尼年龄≥70岁的男性。通过每三年一次的电话随访确定长达4年的跌倒事件。用4个指标（教育程度、职业、收入来源、住房所有权）和累积SES分数评估SES。我们检验了SES指标与出生国家之间的相互作用，并进行了分层分析。
我们评估了1624名男性（平均年龄：77.3±5.4岁）。在平均±标准差为42.6±8.7个月的随访期间，766名（47%）参与者报告发生了≥1次跌倒事件。在非分层分析中，SES指标与跌倒之间无关联。在分层分析中，受正规教育较少的澳大利亚出生男性（发病率比[IRR]为1.66，95%置信区间[CI]为1.16 - 2.37，与受教育程度较高者相比）和职业地位较低的男性（1.45；1.09 - 1.93）跌倒率较高。然而，在非主要英语国家出生的男性中，教育水平较低者的跌倒率较低，职业地位方面未发现明显关联。
较低的教育水平和职业地位预示着澳大利亚出生男性的跌倒率较高；在非主要英语国家出生的移民中，教育水平与跌倒率呈相反关系。进一步的研究应在不同人群和环境中检验这些关系，并评估有针对性干预措施。
