Department of Physical Therapy, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Phys Ther. 2024 Oct 2;104(10). doi: 10.1093/ptj/pzae087.
Activity and participation are important for older adults as they are associated with well-being and quality of life. Falls, emergency department (ED) visits, and hospitalizations are adverse health outcomes that impact older adults. Limited research has investigated whether measurement of activity and participation are related to adverse health events in community dwelling older adults. This study sought to examine the association between activity and participation with falls, ED visits, and hospitalization over 1 year in community dwelling older adults.
A secondary analysis of a longitudinal clinical trial of 341 community dwelling older adults was conducted. The sample mean age was 80.9 (SD = 7.7) years and 83% were female. One-year risk of falls was associated with baseline Late Life Function and Disability Instrument (LLFDI) components of overall function and disability (frequency and limitations dimensions). Incident rate ratios (IRRs) and 95% CIs were calculated.
For each five-point higher score (clinically meaningful difference) in activity as measured by LLFDI-overall function (adjusted for age, race, sex, comorbidities and fall history), there was an 18% lower rate of falls (IRR = 0.82, 95% CI = 0.74-0.92), 12% reduction in hospitalizations (IRR = 0.88; 95% CI = 0.77-0.99), and 11% lower rate of emergency room visits (IRR = 0.89, 95% CI = 0.81-0.98). Greater participation as measured by the LLFDI limitations dimension was related to fewer falls (IRR = 0.93, 95% CI = 0.87-1.00) and hospitalizations (IRR = 0.91, 95% CI = 0.83-0.99).
Greater activity and participation are associated with a lower incidence of falls, ED visits, and hospitalizations representing an important consideration for targeted physical therapist interventions.
Physical therapists are uniquely positioned to identify and address reduced activity and participation. If activity and participation are specifically targeted and improved through physical therapy, undesirable distal health outcomes might be prevented or minimized.
Greater activity and participation were found to be related to lower rate of falls, ED visits, and hospitalizations in a sample of 341 older adults who lived in the community.
活动和参与对老年人很重要，因为它们与幸福感和生活质量有关。跌倒、急诊部（ED）就诊和住院是影响老年人的不良健康后果。有限的研究调查了活动和参与的测量是否与社区居住的老年人的不良健康事件有关。本研究旨在探讨社区居住的老年人在一年内活动和参与与跌倒、ED 就诊和住院之间的关系。
对一项针对 341 名社区居住老年人的纵向临床试验进行了二次分析。样本平均年龄为 80.9（SD=7.7）岁，83%为女性。一年的跌倒风险与基线晚期生活功能和残疾工具（LLFDI）的整体功能和残疾（频率和限制维度）的组成部分相关。计算了发病率比（IRR）和 95%置信区间（CI）。
对于 LLFDI-整体功能测量的每五分（临床有意义的差异）更高的活动得分（调整年龄、种族、性别、合并症和跌倒史），跌倒率降低 18%（IRR=0.82，95%CI=0.74-0.92），住院率降低 12%（IRR=0.88；95%CI=0.77-0.99），急诊室就诊率降低 11%（IRR=0.89，95%CI=0.81-0.98）。LLFDI 限制维度测量的更多参与与跌倒（IRR=0.93，95%CI=0.87-1.00）和住院（IRR=0.91，95%CI=0.83-0.99）的减少有关。
更多的活动和参与与跌倒、ED 就诊和住院的发生率较低相关，这是物理治疗师有针对性干预的重要考虑因素。
物理治疗师的位置独特，可以识别和解决活动和参与度降低的问题。如果通过物理治疗专门针对和改善活动和参与度，可能会预防或最小化不良的远端健康后果。
在一项针对 341 名居住在社区的老年人的样本中，发现更多的活动和参与与跌倒、急诊就诊和住院的发生率较低有关。
