Liu Minhui, Hou Tianxue, Li Yuxiao, Sun Xiaocao, Szanton Sarah L, Clemson Lindy, Davidson Patricia M
Central South University Xiangya School of Nursing, 172 Tongzipo Road of Yuelu District, Hunan, 410013, Changsha, China.
Johns Hopkins University School of Nursing, MD, Baltimore, USA.
BMC Geriatr. 2021 Jun 7;21(1):350. doi: 10.1186/s12877-021-02305-8.
Fear of falling and previous falls are both risk factors that affect daily activities of older adults. However, it remains unclear whether they independently limit daily activities accounting for each other.
We used the data from Round 1 (Year 1) to Round 5 (Year 5) of the National Health and Aging Trends Study. We included a total of 864 community-dwelling participants who provided data on previous falls, fear of falling and limited activities from Year 1 to Year 5 and had no limited daily activities at Year 1 in this study. Previous falls and fear of falling were ascertained by asking participants how many falls they had in the past year and whether they had worried about falling in the last month. Limited daily activities included any difficulties with mobility (e.g., going outside), self-care (e.g., eating), and household activities (e.g., laundering). Generalized estimation equation models were used to examine whether previous falls and fear of falling independently predicted development of limited daily activities adjusting covariates.
Participants were mainly between 65 and 79 years old (83 %), male (57 %), and non-Hispanic White (79 %). Among participants who had multiple falls in Year 1, 19.1-31 %, 21.4-52.4 %, and 11.9-35.7 % developed limitations in mobility, self-care, and household activities during Year 2 to Year 5, respectively. Among those who had fear of falling in Year 1, 22.5-41.3 %, 30.0-55.0 %, and 18.8-36.3 % developed limitations in mobility, self-care, and household activities during Year 2 to Year 4, respectively. Fear of falling independently predicted limitations in mobility (Incidence rate ratio [IRR]: 1.79, 95 % CI: 1.44, 2.24), self-care (IRR: 1.25, 95 % CI: 1.08, 1.44) and household activities (IRR: 1.39, 95 % CI: 1.08, 1.78) after adjusting for previous falls and covariates. Multiple previous falls independently predicted limitations in mobility (IRR: 1.72, 1.30, 2.27), self-care (IRR: 1.40, 95 % CI: 1.19, 1.66) and household activities (IRR: 1.36, 95 % CI: 1.01, 1.83) after adjusting fear of falling and covariates.
Fear of falling seems to be as important as multiple previous falls in terms of limiting older adults' daily activities.
害怕跌倒和既往跌倒都是影响老年人日常活动的风险因素。然而，它们是否相互独立地限制日常活动，同时又相互影响，仍不清楚。
我们使用了国家健康与老龄化趋势研究第1轮（第1年）至第5轮（第5年）的数据。本研究纳入了864名社区居住参与者，他们提供了从第1年到第5年的既往跌倒、害怕跌倒和活动受限的数据，且在第1年时日常活动没有受限。通过询问参与者过去一年跌倒的次数以及过去一个月是否担心跌倒来确定既往跌倒和害怕跌倒情况。活动受限包括行动（如外出）、自我护理（如进食）和家务活动（如洗衣）方面的任何困难。使用广义估计方程模型来检验既往跌倒和害怕跌倒在调整协变量后是否能独立预测活动受限的发展情况。
参与者主要年龄在65至79岁之间（83%），男性（57%），非西班牙裔白人（79%）。在第1年有多次跌倒的参与者中，分别有19.1% - 31%、21.4% - 52.4%和11.9% - 35.7%在第2年至第5年出现了行动、自我护理和家务活动方面的受限。在第1年有害怕跌倒的参与者中，分别有22.5% - 41.3%、30.0% - 55.0%和18.8% - 36.3%在第2年至第4年出现了行动、自我护理和家务活动方面的受限。在调整既往跌倒和协变量后，害怕跌倒独立预测了行动受限（发病率比[IRR]：1.79，95%置信区间：1.44，2.24）、自我护理受限（IRR：1.25，95%置信区间：1.08，1.44）和家务活动受限（IRR：1.39，95%置信区间：1.08，1.78）。多次既往跌倒在调整害怕跌倒和协变量后独立预测了行动受限（IRR：1.72，1.30，2.27）、自我护理受限（IRR：1.40，95%置信区间：1.19，1.66）和家务活动受限（IRR：1.36，95%置信区间：1.01，1.83）。
就限制老年人的日常活动而言，害怕跌倒似乎与多次既往跌倒同样重要。
