Department of Geriatrics, Beijing Tongren Hospital, Capital Medical University, No.1 of Dong Jiao Min Xiang, Dongcheng District, Beijing, 100730, China.
Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Dongcheng District, Capital Medical University, Beijing Institute of Otolaryngology, Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, No.1 of Dong Jiao Min Xiang, Beijing, 100730, China.
BMC Geriatr. 2023 Sep 15;23(1):564. doi: 10.1186/s12877-023-04274-6.
Fear of falling is a potential consequence for older adults who have experienced a fall. Whether such psychological concerns related to falls, in turn, affect physical function? Especially those who have a history of falling but have not been diagnosed with anxiety, depression, or both. This study aimed to clarify the effects of early psychological changes on the physical function of older patients.
The 111 participants with falling history were divided into the poor physical function (PPF) group with the Short Physical Performance Battery (SPPB) ≤ 9 and the good physical function (GPF) group with SPPB > 9. Their physical function was assessed through 4-m gait speed (4MGS), five times sit-to-stand test (FTSST), grip strength, and Timed Up and Go tests TUGT. Their mental state was assessed by the self-rating anxiety/depression scale (SAS/SDS).
(1) SAS/SDS scores were negatively correlated with the SPPB score, gait speed, and maximum grip strength (males). (2) Multivariate logistic regression analysis showed that the SPPB score was subject to such independent influence factors: cerebrovascular disease (OR = 11.805; P = 0.005), normal ratio of grip strength (OR = 0.046; P = 0.016), TUGT (OR = 1.717; P < 0.001), and SDS score (OR = 1.154; P = 0.008). (3) The area under the ROC curve was 0.699 (0.601, 0.797) for SAS score, with a sensitivity of 0.776 and a specificity of 0.547; the AUC was 0.694 (0.596, 0.792) for SDS score, with a sensitivity of 0.586 and a specificity of 0.755.
In older adults with a history of falls without a diagnosis of anxiety or depression, higher SAS/SDS scores were associated with worse fall-related physical function, and there was a statistically significant correlation between the two. This may indicate a risk of falling again in the future.
有跌倒经历的老年人可能会产生害怕跌倒的心理。那么这种与跌倒相关的心理顾虑是否会反过来影响身体机能？特别是那些有跌倒史但未被诊断为焦虑、抑郁或两者兼有的老年人。本研究旨在阐明早期心理变化对老年患者身体机能的影响。
将 111 名有跌倒史的参与者分为简易体能状况量表（SPPB）评分≤9 的身体机能较差（PPF）组和 SPPB 评分>9 的身体机能较好（GPF）组。通过 4 米步行速度（4MGS）、五次坐立站起测试（FTSST）、握力和计时起立行走测试（TUGT）评估他们的身体机能。通过自评焦虑/抑郁量表（SAS/SDS）评估他们的精神状态。
（1）SAS/SDS 评分与 SPPB 评分、步行速度和最大握力（男性）呈负相关。（2）多变量逻辑回归分析显示，SPPB 评分受到以下独立影响因素的影响：脑血管疾病（OR=11.805；P=0.005）、握力正常比值（OR=0.046；P=0.016）、TUGT（OR=1.717；P<0.001）和 SDS 评分（OR=1.154；P=0.008）。（3）SAS 评分的 ROC 曲线下面积为 0.699（0.601，0.797），灵敏度为 0.776，特异性为 0.547；SDS 评分的 AUC 为 0.694（0.596，0.792），灵敏度为 0.586，特异性为 0.755。
在无焦虑或抑郁诊断的有跌倒史的老年人中，较高的 SAS/SDS 评分与较差的与跌倒相关的身体机能相关，两者之间存在统计学显著相关性。这可能表明他们未来有再次跌倒的风险。
