Suh Minhee, Kim Da Hye, Cho Insook, Ham Ok Kyung
PhD, RN, Associate Professor, Department of Nursing, Inha University, Incheon, South Korea.
RN, Doctoral Candidate and Visiting Professor, Department of Nursing, Inha University, Incheon, South Korea.
J Nurs Res. 2023 Apr 1;31(2):e270. doi: 10.1097/jnr.0000000000000545.
Falls are one of the major adverse events affecting older adults that can result in serious injuries. Hospitalizations and deaths because of fall-related injuries have been increasing. Nevertheless, there is a dearth of studies examining the physical condition and current exercise habits of older adults. Moreover, studies analyzing the role of factors related to fall risk by age and gender in large populations are also scarce.
This study was designed to investigate the prevalence of falls among community-dwelling older adults and elucidate the effects of age and gender on the related factors using a biopsychosocial model.
This cross-sectional study utilized data from the 2017 National Survey of Older Koreans. On the basis of the biopsychosocial model, the biological factors related to falls included chronic diseases, number of medications, visual difficulties, activity of daily living (ADL) dependence, lower-limb muscle strength, and physical performance; psychological factors included depression, cognitive ability, regular smoking, alcohol consumption, nutritional status, and exercise; and the social factors included educational level, annual income, living conditions, and instrumental ADL dependence.
Of the 10,073 older adults surveyed, 57.5% were women and approximately 15.7% had experienced falls. The results of the logistic regression showed that, in men, falls were significantly associated with taking more medications and being able to climb 10 stair steps; in women, falls were significantly associated with poor nutritional status and instrumental ADL dependence; and in both genders, falls were significantly associated with greater depression, ADL dependence, and the presence of more chronic diseases and negatively associated with physical performance.
CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The results suggest that practicing kneeling and squatting is the most effective strategy for reducing fall risk in older adult men and that improving nutritional status and strengthening physical ability is the most effective strategy for reducing fall risk in older adult women.
跌倒属于影响老年人的主要不良事件之一，可能导致严重损伤。因跌倒相关损伤导致的住院和死亡人数一直在增加。然而，针对老年人身体状况和当前运动习惯的研究匮乏。此外，在大量人群中按年龄和性别分析与跌倒风险相关因素作用的研究也很少。
本研究旨在调查社区居住老年人中跌倒的患病率，并使用生物心理社会模型阐明年龄和性别对相关因素的影响。
这项横断面研究利用了2017年韩国老年人全国调查的数据。基于生物心理社会模型，与跌倒相关的生物因素包括慢性病、用药数量、视力困难、日常生活活动（ADL）依赖、下肢肌肉力量和身体机能；心理因素包括抑郁、认知能力、经常吸烟、饮酒、营养状况和运动；社会因素包括教育水平、年收入、生活条件和工具性ADL依赖。
在接受调查的10073名老年人中，57.5%为女性，约15.7%曾经历过跌倒。逻辑回归结果显示，在男性中，跌倒与服用更多药物以及能够攀爬10级楼梯显著相关；在女性中，跌倒与营养状况不佳和工具性ADL依赖显著相关；在两性中，跌倒与更严重的抑郁、ADL依赖、更多慢性病的存在显著相关，与身体机能呈负相关。
结论/对实践的启示：结果表明，练习跪姿和蹲姿是降低老年男性跌倒风险的最有效策略，改善营养状况和增强身体能力是降低老年女性跌倒风险的最有效策略。
