Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Centre, Stockholm, Sweden; Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Women's Health and Allied Health Professionals Theme, Medical Unit Medical Psychology, Karolinska University Hospital, Stockholm, Sweden.
Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
J Am Med Dir Assoc. 2023 Dec;24(12):1984-1989.e2. doi: 10.1016/j.jamda.2023.07.015. Epub 2023 Aug 16.
We aimed to examine the extent to which concerns about falling are associated with the risk of injurious falls in older adults, and to explore the role of balance impairment in this association.
Prospective study with a 5-year follow-up.
Participants were 1281 people, aged ≥60 years (62.5% women), from the Swedish National Study on Aging and Care in Kungsholmen.
Data on injurious falls during 5 years of follow-up was obtained from national registers. Cox and Laplace regression models were applied to examine injurious falls in relation to concerns about falling (binary variable), balance impairment (one-leg balance test), or an indicator variable with 4 mutually exclusive categories based on the presence of concerns about falling and balance impairment.
There was no statistically significant association between concerns about falling and injurious falls in the total sample when adjusting for covariates. We found significant interactions of concerns about falling with balance impairment and age (<70 vs ≥80 years), so that the association between concerns about falling and injurious falls was more evident in people with better balance and the younger-old participants (P < .05). Having only concerns about falling [hazard ratio (HR) 2.06, 95% CI 1.22, 3.48], only balance impairment (HR 2.22, 95% CI 1.38, 3.56), or both (HR 2.35, 95% CI 1.45, 3.82) were associated with an increased risk of injurious falls compared to those with neither concerns about falling nor balance impairment.
Our results suggest that concerns about falling may increase the risk of injurious falls, especially among younger-old people or those without objective balance impairment.
我们旨在研究对跌倒的担忧与老年人受伤性跌倒风险之间的关联程度，并探讨平衡障碍在这种关联中的作用。
前瞻性研究，随访 5 年。
参与者为 1281 名年龄≥60 岁的瑞典 Kungsholmen 老龄化和护理国家研究的人（62.5%为女性）。
通过国家登记册获得 5 年随访期间受伤性跌倒的数据。应用 Cox 和拉普拉斯回归模型，研究了与担忧跌倒（二元变量）、平衡障碍（单腿平衡测试）或基于担忧跌倒和平衡障碍的存在有 4 个互斥类别的指标变量相关的受伤性跌倒。
在调整了协变量后，总样本中对跌倒的担忧与受伤性跌倒之间没有统计学显著关联。我们发现对跌倒的担忧与平衡障碍和年龄（<70 岁与≥80 岁）之间存在显著交互作用，因此，在平衡较好的人群和年轻老年人（P<.05）中，对跌倒的担忧与受伤性跌倒之间的关联更为明显。仅对跌倒的担忧[危险比（HR）2.06，95%可信区间（CI）1.22，3.48]、仅平衡障碍（HR 2.22，95%CI 1.38，3.56）或两者（HR 2.35，95%CI 1.45，3.82）与受伤性跌倒的风险增加相关，与既无跌倒担忧也无平衡障碍的人相比。
我们的结果表明，对跌倒的担忧可能会增加受伤性跌倒的风险，尤其是在年轻老年人或无客观平衡障碍的人群中。
