Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, Obu, Japan.
J Am Med Dir Assoc. 2024 Sep;25(9):105123. doi: 10.1016/j.jamda.2024.105123. Epub 2024 Jun 28.
The purpose of this study was to determine the associations of vision impairment, hearing impairment, and comorbid vision and hearing impairment [ie, dual sensory impairment (DSI)] on admission to hospital with falls within 3 months of discharge in older patients.
This prospective multicenter study included patients admitted to and discharged from geriatric wards at 3 university hospitals and 1 national medical center in Japan between October 2019 and July 2023.
Of 1848 individuals enrolled during the study period, 1141 were excluded, leaving 707 for inclusion in the analysis.
Participants' background factors were compared in terms of whether they had a fall during the 3 months postdischarge. Logistic regression analysis was then performed using the presence or absence of falls after discharge as the objective variable. Three models were created using vision impairment, hearing impairment, and DSI as covariates. Other covariates included physical function, cognitive function, and depression. In addition, logistic regression analysis was performed with falls during hospitalization as the objective variable.
DSI was significantly more common in the falls group (P = .004). Logistic regression analysis showed that the risk of falls after discharge was higher in patients with DSI (odds ratio 3.432, P = .006) than in those with vision or hearing impairment alone. When adjusted for physical function, cognitive function, depression, and discharge location, DSI was significantly associated with an increased risk of falls after discharge (odds ratio 3.107, P = .021). The association between DSI and falls during hospitalization did not reach statistical significance, but a trend was observed.
This study is the first to show an association between DSI and falls after discharge. Simple interventions for patients with DSI may be effective in preventing falls, and we suggest that they be actively implemented early during hospitalization.
本研究旨在确定视力障碍、听力障碍以及视力和听力双重障碍（即双重感觉障碍，DSI）与老年人出院后 3 个月内入院时跌倒的相关性。
这是一项前瞻性多中心研究，纳入了 2019 年 10 月至 2023 年 7 月期间在日本 3 所大学医院和 1 所国立医疗中心的老年病房住院和出院的患者。
在研究期间共纳入了 1848 名患者，其中 1141 名被排除，707 名患者纳入分析。
比较了参与者出院后 3 个月内是否发生跌倒的背景因素。然后，使用出院后是否发生跌倒作为因变量，使用逻辑回归分析。使用视力障碍、听力障碍和 DSI 作为协变量，创建了 3 个模型。其他协变量包括身体功能、认知功能和抑郁。此外，还使用住院期间发生跌倒作为因变量进行了逻辑回归分析。
DSI 在跌倒组中更为常见（P=.004）。逻辑回归分析显示，与仅存在视力或听力障碍的患者相比，DSI 患者出院后跌倒的风险更高（优势比 3.432，P=.006）。在校正身体功能、认知功能、抑郁和出院地点后，DSI 与出院后跌倒的风险增加显著相关（优势比 3.107，P=.021）。DSI 与住院期间跌倒的相关性未达到统计学意义，但存在趋势。
本研究首次表明 DSI 与出院后跌倒相关。针对 DSI 患者的简单干预措施可能有助于预防跌倒，我们建议在住院期间早期积极实施。
