Population Health Data Science, Swansea University Medical School, Swansea University, Swansea, Wales, UK.
Care & Repair Cymru, Cardiff, Wales, UK.
Age Ageing. 2022 Aug 2;51(8). doi: 10.1093/ageing/afac176.
falls are common in older people, but associations between falls, dementia and frailty are relatively unknown. The impact of the COVID-19 pandemic on falls admissions has not been studied.
to investigate the impact of dementia, frailty, deprivation, previous falls and the differences between years for falls resulting in an emergency department (ED) or hospital admission.
longitudinal cross-sectional observational study.
older people (aged 65+) resident in Wales between 1 January 2010 and 31 December 2020.
we created a binary (yes/no) indicator for a fall resulting in an attendance to an ED, hospital or both, per person, per year. We analysed the outcomes using multilevel logistic and multinomial models.
we analysed a total of 5,141,244 person years of data from 781,081 individuals. Fall admission rates were highest in 2012 (4.27%) and lowest in 2020 (4.27%). We found an increased odds ratio (OR [95% confidence interval]) of a fall admission for age (1.05 [1.05, 1.05] per year of age), people with dementia (2.03 [2.00, 2.06]) and people who had a previous fall (2.55 [2.51, 2.60]). Compared with fit individuals, those with frailty had ORs of 1.60 [1.58, 1.62], 2.24 [2.21, 2.28] and 2.94 [2.89, 3.00] for mild, moderate and severe frailty respectively. Reduced odds were observed for males (0.73 [0.73, 0.74]) and less deprived areas; most deprived compared with least OR 0.75 [0.74, 0.76].
falls prevention should be targeted to those at highest risk, and investigations into the reduction in admissions in 2020 is warranted.
老年人经常跌倒，但跌倒、痴呆和虚弱之间的关联尚不清楚。COVID-19 大流行对跌倒入院的影响尚未研究。
研究痴呆、虚弱、贫困、既往跌倒以及导致急诊科（ED）或住院的跌倒年份之间的差异对跌倒的影响。
纵向横断面观察研究。
2010 年 1 月 1 日至 2020 年 12 月 31 日期间居住在威尔士的 65 岁以上老年人。
我们为每个人每年创建了一个导致 ED、医院或两者就诊的跌倒的二进制（是/否）指标。我们使用多水平逻辑和多项模型分析了结果。
我们分析了来自 781,081 人的 5,141,244 人年的数据。跌倒入院率在 2012 年最高（4.27%），在 2020 年最低（4.27%）。我们发现，跌倒入院的优势比（OR [95%置信区间]）随着年龄的增长而增加（每年增加 1.05 [1.05, 1.05]）、痴呆症患者（2.03 [2.00, 2.06]）和既往跌倒患者（2.55 [2.51, 2.60]）。与健康个体相比，虚弱的个体轻度、中度和重度虚弱的 OR 分别为 1.60 [1.58, 1.62]、2.24 [2.21, 2.28]和 2.94 [2.89, 3.00]。男性（0.73 [0.73, 0.74]）和贫困程度较低的地区观察到的几率降低；与最不贫困地区相比，最贫困地区的 OR 为 0.75 [0.74, 0.76]。
应针对高风险人群进行跌倒预防，并且有必要对 2020 年入院人数减少进行调查。
