Jeonbuk National University, Deokjin-gu, Jeonju-si, Jeollabuk-do, Jeonju, Republic of Korea.
Wonkwang Health Science University, Iksan-si, Jeollabuk-do, Republic of Korea.
Inquiry. 2024 Jan-Dec;61:469580241273173. doi: 10.1177/00469580241273173.
This study aimed to identify the risk factors for falls among older individuals living at home in a community and develop a nomogram to predict falls. This study included 74 492 people aged 65 years or older who participated in the 2021 Community Health Survey conducted in Korea. The data analysis methods used included the Rao-Scott χ test, a complex sample -test, and complex binary logistic regression using SPSS 26.0. Using logistic regression analysis, a fall-risk prediction nomogram was created based on regression coefficients, and the reliability of the nomogram was calculated using a receiver operating characteristic (ROC) curve and values of the area under the curve (AUC). The fall incidence rate among older adults was 16.4%. Factors affecting the subject's fall experience included being more than 85 years old (OR = 1.40); living alone (OR = 1.13); receiving basic welfare (OR = 1.18); subjective health status (OR = 1.72); number of days spent walking (OR = 0.98); obesity (OR = 1.08); severe depression (OR = 2.84); sleep duration time (OR = 1.11); experiencing cognitive decline (OR = 1.34); and diabetes (OR = 1.12). In the nomogram, the depression score exhibited the greatest discriminatory power, followed by subjective health status, gender, experience of cognitive decline, age, basic livelihood security, adequacy of sleep, living alone, diabetes, and number of days of walking. The AUC value was 0.66. An intervention plan that comprehensively considers physical, psychological, and social factors is required to prevent falls in older adults. The nomogram developed in this study will help local health institutions assess all these risk factors for falling and create and implement systematic education and intervention programs to prevent falls and fall-related injuries among older individuals.
本研究旨在确定居家社区老年个体跌倒的风险因素,并制定预测跌倒的诺模图。本研究纳入了 2021 年韩国社区健康调查中 74492 名 65 岁及以上的老年人。数据分析方法包括 Rao-Scott χ 检验、复杂样本 t 检验和使用 SPSS 26.0 的复杂二项逻辑回归。使用逻辑回归分析,根据回归系数创建了跌倒风险预测诺模图,并通过接受者操作特征(ROC)曲线和曲线下面积(AUC)值计算了诺模图的可靠性。老年人的跌倒发生率为 16.4%。影响受试者跌倒经历的因素包括年龄超过 85 岁(OR=1.40);独居(OR=1.13);接受基本福利(OR=1.18);主观健康状况(OR=1.72);步行天数(OR=0.98);肥胖(OR=1.08);严重抑郁(OR=2.84);睡眠时间(OR=1.11);认知能力下降(OR=1.34);以及糖尿病(OR=1.12)。在诺模图中,抑郁得分表现出最大的判别能力,其次是主观健康状况、性别、认知能力下降经历、年龄、基本生计保障、睡眠充足程度、独居、糖尿病和步行天数。AUC 值为 0.66。需要制定一个综合考虑身体、心理和社会因素的干预计划,以预防老年人跌倒。本研究制定的诺模图将有助于当地卫生机构评估所有这些跌倒风险因素,并制定和实施系统的教育和干预计划,以预防老年人跌倒和跌倒相关伤害。