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COVID-19 大流行前后跌倒率的变化:前瞻性 AMBROSIA 研究的结果。

Changes in Fall Rates From Before to During the COVID-19 Pandemic: Findings From the Prospective AMBROSIA Study.

机构信息

Durham Veterans Affairs Geriatric Research Education and Clinical Center, Durham Veterans Affairs Medical Center (VAMC), Durham, North Carolina, USA.

Department of Medicine, Duke University, Durham, North Carolina, USA.

出版信息

J Gerontol A Biol Sci Med Sci. 2023 Mar 30;78(4):624-629. doi: 10.1093/gerona/glac131.

Abstract

BACKGROUND

Coronavirus disease 2019 (COVID-19) social distancing policies resulted in reductions in community movement, however, fall rates during this time have not been described.

METHODS

This prospective study included adults ≥65 years old participating in the Ambulatory Blood Pressure in Older Adults (AMBROSIA) cohort and who completed ≥1 monthly falls calendar (August 2019-March 2021; n = 250). Months were grouped to correspond to the fall 2020 phased reopening (August-October) and the shelter-in-place policy during the winter 2020 surge (November-January) in Los Angeles, California and compared to the same months, 1 year earlier (ie, before the pandemic).

RESULTS

Participants had a mean (standard deviation [SD]) age of 75.2 (6.1) years, 49.6% were White, and 53.2% were women. We obtained 2 795 falls calendars during follow-up. Overall, 110 (44.0%) participants reported a total of 421 falls (rate 15.1 per 100 calendar months). The highest monthly fall rate during the pandemic was 22.9 (95% confidence interval [CI] 16.4-31.1) per 100 calendar-months in August 2020. The lowest fall rate during the pandemic was 8.6 (95% CI 3.5-17.8) per 100 calendar-months in February 2021. During the pandemic, fall rates in August, September, and October 2020 were higher than the previous year (rate ratio 1.8 [95% CI 1.1-2.9]), and fall rates in November and December 2020 and January 2021 were lower than the previous year (rate ratio 0.5 [95% CI 0.4-0.8]).

CONCLUSION

As the pandemic continues and older adults resume community mobility after a shelter-in-place period, providers should pay attention to the risk of falls.

摘要

背景

2019 年冠状病毒病(COVID-19)的社交距离政策导致社区活动减少,但在此期间跌倒的发生率尚未描述。

方法

本前瞻性研究纳入了参加老年人动态血压(AMBROSIA)队列且完成≥1 份每月跌倒日历(2019 年 8 月至 2021 年 3 月;n=250)的≥65 岁成年人。将月份分组以对应于 2020 年秋季分阶段重新开放(8 月至 10 月)和加利福尼亚州洛杉矶 2020 年冬季疫情高峰期的就地避难政策(11 月至 1 月),并与 1 年前(即大流行前)的相同月份进行比较。

结果

参与者的平均(标准差[SD])年龄为 75.2(6.1)岁,49.6%为白人,53.2%为女性。在随访期间,我们共获得 2795 份跌倒日历。总体而言,110(44.0%)名参与者共报告了 421 次跌倒(每 100 个日历月发生率为 15.1)。疫情期间最高的每月跌倒率为 2020 年 8 月的 22.9(95%置信区间[CI]16.4-31.1)每 100 个日历月。疫情期间最低的跌倒率为 2021 年 2 月的 8.6(95%CI3.5-17.8)每 100 个日历月。在疫情期间,2020 年 8 月、9 月和 10 月的跌倒率高于前一年(发生率比 1.8[95%CI1.1-2.9]),而 2020 年 11 月和 12 月以及 2021 年 1 月的跌倒率低于前一年(发生率比 0.5[95%CI0.4-0.8])。

结论

随着大流行的继续,老年人在就地避难期后恢复社区活动,医务人员应注意跌倒的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb11/10061562/d25b0dfb00f0/glac131f0001.jpg

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