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跌倒史和对跌倒的恐惧与独立社区居住的老年人多维认知功能的关联:来自 ORANGE 研究的结果。

Associations of fall history and fear of falling with multidimensional cognitive function in independent community-dwelling older adults: findings from ORANGE study.

机构信息

Graduate School of Health Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.

Department of Rehabilitation, Japan Community Health Care Organization Kumamoto General Hospital, 10-10 Toricho, Yatsushiro, Kumamoto, 866-8660, Japan.

出版信息

Aging Clin Exp Res. 2022 Dec;34(12):2985-2992. doi: 10.1007/s40520-022-02235-4. Epub 2022 Sep 1.

Abstract

BACKGROUND

Falls and fear of falling (FoF) inhibit healthy longevity and have been suggested to be associated with cognitive function. However, the domains of cognitive function that are associated with them remain controversial. It is speculated that clarifying this will help in the assessment of health status and interventions in the community.

AIM

To analyse the associations between fall history and FoF and multidimensional cognitive function in independent community-dwelling older adults.

METHODS

The data from 9759 (73.3 ± 5.4 years, 59.9% women) older individuals enrolled in the cross-sectional ORANGE study were analysed. Simple questions were used to assess fall history in the past year and current FoF. Assessments of multidimensional cognitive function were performed using the National Center for Geriatrics and Gerontology-Functional Assessment Tool (NCGG-FAT) to evaluate memory, attention, executive function, and processing speed. The independent associations of fall history and FoF with multidimensional cognitive function were assessed using multivariate linear regressions adjusted for potential confounding variables.

RESULTS

A total of 18.3% and 35.4% of participants presented with fall history and FoF, respectively. Fall history (p = 0.008) and FoF (p = 0.002) were significantly associated with memory. FoF, but not fall history was associated with attention (p = 0.004), executive function (p < 0.01), and processing speed (p < 0.01).

CONCLUSION

In independent community-dwelling older adults, fall history was associated only with the memory domain; in contrast, fear of falling was associated with multidimensional cognitive function. This study provides weak evidence suggesting the need to assess falls and FoF in all situations involving independent community-dwelling older adults.

摘要

背景

跌倒和跌倒恐惧会抑制健康长寿,并与认知功能有关。然而,与它们相关的认知功能领域仍存在争议。据推测,澄清这一点将有助于评估健康状况和社区干预。

目的

分析跌倒史和跌倒恐惧与独立社区居住的老年人多维认知功能之间的关系。

方法

分析了横断面 ORANGE 研究中 9759 名(73.3±5.4 岁,59.9%为女性)独立社区居住的老年人的数据。简单的问题用于评估过去一年的跌倒史和当前的跌倒恐惧。使用国家老年医学和老年病学中心功能评估工具(NCGG-FAT)评估多维认知功能,评估记忆、注意力、执行功能和处理速度。使用多元线性回归调整潜在混杂变量评估跌倒史和跌倒恐惧与多维认知功能的独立关联。

结果

共有 18.3%和 35.4%的参与者分别出现跌倒史和跌倒恐惧。跌倒史(p=0.008)和跌倒恐惧(p=0.002)与记忆显著相关。跌倒恐惧(p=0.004),而不是跌倒史,与注意力(p=0.004)、执行功能(p<0.01)和处理速度(p<0.01)相关。

结论

在独立社区居住的老年人中,跌倒史仅与记忆域相关;相反,跌倒恐惧与多维认知功能相关。本研究提供的证据表明,在涉及独立社区居住的老年人的所有情况下,都需要评估跌倒和跌倒恐惧。

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