Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Republic of Korea.
Wonju College of Nursing, Yonsei University, Wonju, Republic of Korea.
J Am Med Dir Assoc. 2023 Oct;24(10):1541-1548.e1. doi: 10.1016/j.jamda.2023.07.004. Epub 2023 Aug 11.
This study investigated the reciprocal longitudinal relationships between physical frailty (PF), cognitive function (CF), and falls among community-dwelling older adults, according to sex. The study proposed hypotheses that present PF and CF will affect the occurrence of falls 2 years later.
Secondary data analysis using the first (T1, 2016-2017) and second (T2, 2018-2019) waves of the Korean Frailty and Aging Cohort Study (KFACS).
A total of 2318 community-dwelling older adults aged 70-84 years in South Korea; mean (SD) age: 75.72 (3.83) years; 47.7% men.
PF and CF were measured with the modified version of the Fried Frailty Phenotype and the Korean version of the Mini-Mental State Examination, respectively. The number of falls were assessed. Multigroup cross-lagged panel analysis was used.
The results showed that relationships between PF, CF, and falls were maintained over time through an autoregressive effect. PF at T1 had a statistically significant longitudinal relationship with fall experience at T2 [standardized regression coefficient (β) = 0.087, 95% CI 0.045-0.129; P < .001], and fall experience at T1 had a significant longitudinal relationship with PF at T2 (β = 0.041, 95% CI 0.006-0.076; P = .020). There was no statistically significant relationship between CF and fall experience. PF and CF had statistically significant reciprocal longitudinal relationships (all P < .001). Based on sex, there was a statistically significant longitudinal relationship between fall experience at T1 and PF at T2 for men only (β = 0.063, 95% CI 0.012-0.114; P = .015).
Findings highlight that health care providers should plan fall prevention programs through early intervention for PF improvement along with improvement and maintenance of CF. Specifically, even if older men are currently healthy and have a low risk of falls, it is important to prevent future fatal PF through prior interventions, such as risk activities attention and concerns about falls.
本研究根据性别，探讨了社区居住的老年人中身体虚弱（PF）、认知功能（CF）和跌倒之间的相互纵向关系。研究提出了以下假设：目前的 PF 和 CF 将影响 2 年后跌倒的发生。
使用韩国虚弱与衰老队列研究（KFACS）的第一波（T1，2016-2017 年）和第二波（T2，2018-2019 年）的二次数据分析。
共有 2318 名年龄在 70-84 岁的社区居住的韩国老年人；平均（SD）年龄：75.72（3.83）岁；47.7%为男性。
使用改良版的 Fried 虚弱表型和韩国版的简易精神状态检查分别测量 PF 和 CF。评估跌倒次数。使用多组交叉滞后面板分析。
结果表明，通过自回归效应，PF、CF 和跌倒之间的关系在一段时间内保持不变。T1 时的 PF 与 T2 时的跌倒经历有统计学显著的纵向关系（标准化回归系数（β）=0.087，95%CI 0.045-0.129；P<.001），而 T1 时的跌倒经历与 T2 时的 PF 有显著的纵向关系（β=0.041，95%CI 0.006-0.076；P=.020）。CF 与跌倒经历之间没有统计学显著关系。PF 和 CF 之间存在统计学显著的相互纵向关系（均 P<.001）。基于性别，仅男性 T1 时的跌倒经历与 T2 时的 PF 之间存在统计学显著的纵向关系（β=0.063，95%CI 0.012-0.114；P=.015）。
研究结果强调，医护人员应通过早期干预改善 PF，同时改善和维持 CF，计划预防跌倒的方案。具体而言，即使是目前健康且跌倒风险较低的老年男性，也应通过早期干预，如关注高危活动和关注跌倒等，预防未来致命的 PF。
