Hamilton Institute, Maynooth University, Maynooth, Co. Kildare, Ireland.
Department of Psychology, Maynooth University, Maynooth, Co. Kildare, Ireland.
J Am Med Dir Assoc. 2024 Aug;25(8):105072. doi: 10.1016/j.jamda.2024.105072. Epub 2024 Jun 8.
Previous studies demonstrated that discrepancies between subjective and objective health measures are associated with physical and mental health-related outcomes in older adults. We investigate whether such discrepancies are also associated with risk of injurious falls in community-dwelling Swedish older adults.
A prospective, observational cohort study.
Using data from the Swedish National Study on Aging and Care in Kungsholmen, we followed 2222 community-dwelling older adults aged ≥60 years at baseline, across a 10-year period of data collection (2001-2011).
A "health asymmetry" metric classified older adults into 4 categories, based on the level of agreement between their subjective and objective health scores ("health pessimist", "health optimist", "poor health realist", and "good health realist"). Time-varying Cox proportional hazard and Laplace regressions were employed to investigate if these categories were associated with the risk of injurious falls.
Over a 10-year follow-up, 23.5% of the sample experienced an injurious fall. Health optimists had the greatest risk of experiencing an injurious fall [hazard ratio (HR) 2.16, 95% confidence interval (CI) 1.66, 2.80], compared with good health realists. Poor health realists (HR 1.77, 95% CI 1.50, 2.11) and health pessimists (HR 1.66, 95% CI 1.21, 2.29) also had an increased risk of experiencing injurious falls, compared with good health realists. Being a health pessimist was only associated with the risk of injurious falls within the younger-old (HR 2.43, 95% CI 1.63, 3.64) and among males (HR 1.95, 95% CI 1.14, 3.33).
Older adults with similar objective health levels may differ in terms of their injurious fall risk, depending on their subjective health. Interpreting subjective health alongside objective health is clinically pertinent when assessing injurious fall risk.
先前的研究表明，主观健康和客观健康测量之间的差异与老年人的身心健康相关结果有关。我们调查这种差异是否也与社区居住的瑞典老年人受伤性跌倒的风险相关。
前瞻性、观察性队列研究。
使用来自瑞典 Kungsholmen 老龄化和护理全国研究的数据，我们在 10 年的数据收集期间（2001-2011 年），对 2222 名基线时年龄≥60 岁的社区居住的老年人进行了随访。
根据主观和客观健康评分之间的一致性水平，将老年人分为 4 类，使用“健康不对称”指标进行分类（“健康悲观主义者”、“健康乐观主义者”、“健康现实主义差”和“健康现实主义好”）。采用时变 Cox 比例风险和拉普拉斯回归来研究这些类别是否与受伤性跌倒的风险相关。
在 10 年的随访期间，样本中有 23.5%的人经历了受伤性跌倒。与健康现实主义者相比，健康乐观主义者受伤性跌倒的风险最高[风险比（HR）2.16，95%置信区间（CI）1.66，2.80]。与健康现实主义者相比，健康现实主义差（HR 1.77，95%CI 1.50，2.11）和健康悲观主义者（HR 1.66，95%CI 1.21，2.29）也有增加受伤性跌倒的风险。健康悲观主义者仅与年轻老年人（HR 2.43，95%CI 1.63，3.64）和男性（HR 1.95，95%CI 1.14，3.33）受伤性跌倒的风险相关。
具有相似客观健康水平的老年人，由于其主观健康状况的不同，受伤性跌倒的风险可能不同。在评估受伤性跌倒风险时，将主观健康与客观健康结合起来进行解释在临床上是有意义的。
