中国东部老年人多病共存与跌倒和跌倒恐惧的关系：一项横断面研究。
Association between multimorbidity and falls and fear of falling among older adults in eastern China: a cross-sectional study.
机构信息
Zhejiang Provincial Center for Disease Control and Prevention, Zhejiang, China.
National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
出版信息
Front Public Health. 2023 May 18;11:1146899. doi: 10.3389/fpubh.2023.1146899. eCollection 2023.
BACKGROUND
Growing evidence has reported an association between multimorbidity and falls and fear of falling (FOF) in older adults, however, the results regarding this association from China are limited. Our study aimed to investigate the association between multimorbidity and falls and FOF in older adults in eastern China.
METHODS
We conducted a cross-sectional study in Zhejiang Province, Eastern China, which recruited a provincial representative sample of adults aged ≥ 60 years. A structured questionnaire including demographic characteristics, chronic diseases, history of falls in the past 12 months, and FOF, was administered by all participants. The exposure variable was multimorbidity, which was defined as the presence of two or more chronic diseases and medical conditions in the same individual. The outcomes included a history of falls and FOF. Multivariate logistic regression was used to evaluate the association between multimorbidity and falls and FOF in older adults.
RESULTS
In total of 7,774 participants were included in the analysis, among whom 3,898 (50.1%) were female, with a mean ± standard deviation age is 72.9 ± 8.4 years. Multimorbidity was associated with the increased risk of falling in older adults [adjusted odds ratio (OR), 1.99; 95% confidence interval (CI):1.55-2.36]. The ORs for having experienced single fall and repeated falls were 1.85 (95% CI: 1.42-2.42) and 3.45 (95% CI: 1.47-6.97), respectively, with multimorbidity compared with those without chronic diseases. The older adults with multimorbidity were more likely to report FOF compared with those without chronic diseases (adjusted OR, 1.49; 95%CI:1.30-1.70). Moreover, the association between multimorbidity and FOF remained significant in the older adults with a history of fall (OR, 1.57; 95%CI:1.04-2.38).
CONCLUSION
The association between multimorbidity and falls and FOF is significant in the Chinese population and the effects of multimorbidity on falls and FOF do not vary according to the frequency and history of falls in older adults.
背景
越来越多的证据表明，老年人的多种合并症与跌倒和跌倒恐惧（FOF）有关，然而，来自中国的相关研究结果有限。本研究旨在调查中国东部老年人多种合并症与跌倒和 FOF 之间的关系。
方法
我们在中国东部浙江省进行了一项横断面研究，该研究招募了一个省级代表性的 60 岁及以上成年人样本。所有参与者都填写了一份包括人口统计学特征、慢性疾病、过去 12 个月内跌倒史和 FOF 的结构化问卷。暴露变量是多种合并症，定义为同一个体存在两种或多种慢性疾病和医疗状况。结果包括跌倒和 FOF 史。多变量 logistic 回归用于评估老年人多种合并症与跌倒和 FOF 之间的关系。
结果
共有 7774 名参与者纳入分析，其中 3898 名（50.1%）为女性，平均年龄（均数±标准差）为 72.9±8.4 岁。多种合并症与老年人跌倒风险增加相关（调整后的比值比[OR]，1.99；95%置信区间[CI]：1.55-2.36）。与无慢性疾病相比，有过单次跌倒和多次跌倒经历的参与者发生跌倒的 OR 分别为 1.85（95%CI：1.42-2.42）和 3.45（95%CI：1.47-6.97）。与无慢性疾病的老年人相比，患有多种合并症的老年人更有可能报告 FOF（调整后的 OR，1.49；95%CI：1.30-1.70）。此外，在有跌倒史的老年人中，多种合并症与 FOF 之间的关联仍然显著（OR，1.57；95%CI：1.04-2.38）。
结论
在中国人群中，多种合并症与跌倒和 FOF 显著相关，多种合并症对跌倒和 FOF 的影响与老年人跌倒的频率和既往史无关。
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