Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China.
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China.
J Am Med Dir Assoc. 2024 Aug;25(8):105100. doi: 10.1016/j.jamda.2024.105100. Epub 2024 Jun 19.
To determine whether physical performance measures commonly used in clinical settings can discriminate fallers from nonfallers and predict falls in older adults with dementia.
Systematic review and meta-analysis.
Older adults with dementia residing in the community, hospitals, and residential care facilities.
MEDLINE, Embase, PsycINFO, CINAHL, SPORTDiscus, the Cochrane Library, and the PEDro databases were searched from inception until December 27, 2023 (PROSPERO registration number: CRD42022303670). Retrospective or prospective studies that evaluated the associations between physical performance measures and falls in older adults with dementia were included. A random effects model was used to calculate the standardized mean difference (SMD) and 95% CI for each physical performance measure between fallers and nonfallers. Sensitivity analyses were conducted on the longitudinal studies to determine the ability of physical performance measures to predict future falls.
Twenty-eight studies were included in this review (n = 3542). The 5-time chair stand test [SMD = 0.23 (0.01, 0.45)], the Berg Balance Scale [SMD = -0.52 (-0.87, -0.17)], postural sway when standing on the floor [SMD = 0.25 (0.07, 0.43)] and on a foam surface [SMD = 0.45 (0.25, 0.66)], and the Short Physical Performance Battery total score [SMD = -0.46 (-0.66, -0.27)] could discriminate fallers from nonfallers. Sensitivity analyses showed that gait speed could predict future falls in longitudinal cohort studies [SMD = -0.29 (-0.49, -0.08)]. Subgroup analyses showed that gait speed [SMD = -0.21 (-0.38, -0.05)] and the Timed Up and Go test [SMD = 0.54 (0.16, 0.92)] could identify fallers staying in residential care facilities or hospitals.
The 5-time chair stand test, the Berg Balance Scale, postural sway when standing on the floor and a foam surface, and the Short Physical Performance Battery can be used to predict falls in older adults with dementia. Gait speed and the Timed Up and Go test can be used to predict falls in institutionalized older adults with dementia. Clinicians are recommended to use these physical performance measures to assess fall risk in older adults with dementia.
确定在临床环境中常用的身体表现测量指标是否可以区分跌倒者和非跌倒者，并预测痴呆老年人的跌倒。
系统评价和荟萃分析。
居住在社区、医院和养老院中的痴呆老年人。
从开始到 2023 年 12 月 27 日，在 MEDLINE、Embase、PsycINFO、CINAHL、SPORTDiscus、Cochrane 图书馆和 PEDro 数据库中进行了搜索（PROSPERO 注册号：CRD42022303670）。纳入了评估痴呆老年人身体表现测量指标与跌倒之间关系的回顾性或前瞻性研究。使用随机效应模型计算跌倒者和非跌倒者之间每项身体表现测量指标的标准化均数差（SMD）和 95%置信区间。对纵向研究进行了敏感性分析，以确定身体表现测量指标预测未来跌倒的能力。
本综述纳入了 28 项研究（n=3542）。五次椅站测试[SMD=0.23（0.01，0.45）]、伯格平衡量表[SMD=-0.52（-0.87，-0.17）]、站在地板上时的姿势摆动[SMD=0.25（0.07，0.43）]和泡沫表面[SMD=0.45（0.25，0.66）]，以及简短身体表现电池总分[SMD=-0.46（-0.66，-0.27）]可以区分跌倒者和非跌倒者。敏感性分析显示，步态速度可以预测纵向队列研究中的未来跌倒[SMD=-0.29（-0.49，-0.08）]。亚组分析显示，步态速度[SMD=-0.21（-0.38，-0.05）]和计时起立行走测试[SMD=0.54（0.16，0.92）]可以识别住在养老院或医院的跌倒者。
五次椅站测试、伯格平衡量表、站在地板和泡沫表面时的姿势摆动以及简短身体表现电池可以用于预测痴呆老年人的跌倒。步态速度和计时起立行走测试可用于预测住院痴呆老年人的跌倒。建议临床医生使用这些身体表现测量指标来评估痴呆老年人的跌倒风险。
