青光眼患者跌倒后离家外出活动模式的评估：一项纵向研究。
Evaluation of away-from-home excursion patterns after falling among individuals with glaucoma: a longitudinal study.
机构信息
Wilmer Eye Institute, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Maumenee B110, Baltimore, MD, 21287, USA.
College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA.
出版信息
BMC Geriatr. 2022 Feb 4;22(1):101. doi: 10.1186/s12877-022-02788-z.
BACKGROUND
Unintentional falls among older adults are associated with an ensuing decline in physical activity. Our objective is to evaluate the associations between fall status and changes in excursions after a fall.
METHODS
Prospective cohort study of older adults with glaucoma or suspected glaucoma who reported falls for 1 year and wore a GPS device for 1-week at the baseline and 1 year later. GPS data were quantified into average: daily excursions, daily time away from home, and time per excursion. Fall status was categorized as fallers, injurious fallers, recurrent fallers, and recurrent injurious fallers. Multivariable negative binomial regression and generalized estimating equations models were employed to evaluate relationship between excursion parameters and fall status.
RESULTS
A total of 192 eligible participants were included in the analyses. Approximately half were males (50.5%) with a mean age of 70.1 years and one-fourth were Black (28.1%). There were no significant associations between fall status and end-of-study excursion parameters (p > 0.06 for all), and visual field damage did not modify these relationships (p > 0.07 for all). For instance, patients with multiple falls during a one-year study period did not demonstrate more daily excursions (incident rate ratio [IRR] = 1.16, 95% confidence interval [CI] = 0.85 to 1.57), longer time per excursion (IRR = 0.79, 95% CI =0.59 to 1.06), or more average daily time away (IRR = 1.05, 95% CI = 0.84 to 1.30) conducted at the end-of-the study. Excursion parameters at the final assessment were not significantly different from those at baseline (p > 0.09 for all) and the changes did not vary by fall status (p > 0.23 for all).
CONCLUSIONS
Older adults with glaucoma did not modify their travel away from home after experiencing a fall. Additional research is necessary to understand how often maintenance of travel outside the home after a fall reflects proper compensation for greater fall risk or continued activity despite the risk of falling.
背景
老年人意外跌倒与随后的体力活动减少有关。我们的目的是评估跌倒状态与跌倒后活动范围变化之间的关系。
方法
这是一项对青光眼或疑似青光眼的老年人进行的前瞻性队列研究，这些老年人在 1 年内报告跌倒，并在基线和 1 年后的 1 周内佩戴 GPS 设备。GPS 数据被量化为平均每日活动范围、每日离家时间和每次活动范围的时间。跌倒状态分为跌倒者、受伤跌倒者、复发性跌倒者和复发性受伤跌倒者。采用多变量负二项回归和广义估计方程模型来评估活动范围参数与跌倒状态之间的关系。
结果
共有 192 名符合条件的参与者被纳入分析。大约一半为男性（50.5%），平均年龄为 70.1 岁，四分之一为黑人（28.1%）。在研究结束时，跌倒状态与研究结束时的活动范围参数之间没有显著关联（所有 p 值>0.06），而视野损害并没有改变这些关系（所有 p 值>0.07）。例如，在一项为期 1 年的研究中多次跌倒的患者并没有表现出更多的日常活动范围（发生率比[IRR] = 1.16，95%置信区间[CI] = 0.85 至 1.57）、更长的每次活动范围时间（IRR = 0.79，95%CI = 0.59 至 1.06）或更多的平均每日离家时间（IRR = 1.05，95%CI = 0.84 至 1.30）。在研究结束时，最终评估的活动范围参数与基线时没有显著差异（所有 p 值>0.09），并且变化与跌倒状态无关（所有 p 值>0.23）。
结论
患有青光眼的老年人在经历跌倒后并没有改变他们离家外出的活动范围。需要进一步研究，以了解跌倒后经常外出活动是反映对更高跌倒风险的适当补偿，还是在面临跌倒风险的情况下继续活动。
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