Shanghai Health Development Research Center, (Shanghai Medical Information Center), Shanghai, China.
Minhang Hospital, Fudan University, Shanghai, China.
Front Public Health. 2024 Jun 14;12:1376993. doi: 10.3389/fpubh.2024.1376993. eCollection 2024.
This study explored the correlative factors of falls among the older adult with cognitive impairment, to provide distinct evidence for preventing falls in the older adult with cognitive impairment compared with the general older adult population.
This study was based on a cross-sectional survey, with an older adult population of 124,124 was included. The data was sourced from the Elderly Care Unified Needs Assessment for Long-Term Care Insurance in Shanghai. Binary and multivariable logistic regression analyses were conducted sequentially on the correlative factors of falls. Multivariable logistic regression was performed on variables that were significant, stratified by cognitive function levels.
The incidence of fall in the past 90 days was 17.67% in this study. Specific variables such as gender (male), advanced age (≥80), residence with a elevator (or lift), mild or moderate disability, quality of sleep (acceptable/poor) were negatively correlated with falls, while higher education level, living alone, residence with indoor steps, unclean and untidy living environment, MCI or dementia, chronic diseases, restricted joints, impaired vision, and the use of diaper were positively correlative factors of falls. Comparing with older adult with normal cognitive functions, older adult with dementia faced a higher risk of falling due to accessibility barrier in the residence. For general older adults, less frequency of going outside and poor social interactions were positively correlated with falls, while for older adult with cognitive impairments, going outside moderately (sometimes) was found positively correlated with falls. Older adults with cognitive impairments have increased fall risks associated with chronic diseases, restricted joints, and the use of diaper. The risk of falling escalated with the greater number of chronic diseases.
For older adult with cognitive impairments, it is advisable to live with others. Additionally, creating an accessible living environment and maintaining the cleanness and tidiness can effectively reduce the risk of falls, particularly for those with MCI or dementia. Optimal outdoor activity plans should be developed separately based on the cognitive function of older adults. Older adult with dementia who have comorbidities should be paid special attention in fall prevention compared to the general older adult population.
本研究旨在探讨认知障碍老年人跌倒的相关因素，为预防认知障碍老年人跌倒提供独特证据，与一般老年人人群相比。
本研究基于一项横断面调查，纳入了 124124 名老年人。数据来源于上海长期护理保险老年护理统一需求评估。对跌倒的相关因素进行了二元和多变量逻辑回归分析。对有意义的变量进行了多变量逻辑回归，按认知功能水平进行了分层。
本研究中，过去 90 天内跌倒的发生率为 17.67%。性别（男性）、高龄（≥80 岁）、有电梯（或升降机）的住所、轻度或中度残疾、睡眠质量（可接受/差）等特定变量与跌倒呈负相关，而较高的教育水平、独居、有室内台阶的住所、居住环境不清洁和杂乱、轻度认知障碍或痴呆、慢性病、关节受限、视力障碍以及使用尿布是跌倒的正相关因素。与认知功能正常的老年人相比，痴呆老年人由于住所的可达性障碍，跌倒的风险更高。对于一般老年人来说，外出频率较低和社交互动较差与跌倒呈正相关，而对于认知障碍老年人来说，适度（有时）外出与跌倒呈正相关。认知障碍老年人与慢性病、关节受限和使用尿布有关的跌倒风险增加。随着慢性病数量的增加，跌倒的风险也会增加。
对于认知障碍老年人，与他人同住是明智的。此外，创造一个无障碍的生活环境，保持清洁和整洁，可以有效地降低跌倒的风险，特别是对于有轻度认知障碍或痴呆的老年人。应根据老年人的认知功能制定单独的最佳户外活动计划。与一般老年人人群相比，患有合并症的痴呆老年人在预防跌倒方面应特别注意。
