Farup Per G, Hestad Knut, Engedal Knut
Department of Research, Innlandet Hospital Trust, N-2381 Brumunddal, Norway.
Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, N-7491 Trondheim, Norway.
Geriatrics (Basel). 2024 Dec 22;9(6):168. doi: 10.3390/geriatrics9060168.
The annual incidence of falls is high in older adults with impaired cognitive function and dementia, and injuries have a detrimental effect on disability-adjusted life-years and public health spending. In this registry-based study, fall incidence and characteristics of the fallers were explored in a large population with cognitive impairment. : NorCog, "The Norwegian Registry of Persons Assessed for Cognitive Symptoms", is a national research and quality registry with a biomaterial collection. This study included 9525 persons from the registry who had answered the question about falls. Fall incidence was studied, and the characteristics of fallers and non-fallers were compared. : The annual fall incidence was 3774/9525 (39.6%). The incidence varied between types of dementia, from 22.4% in persons with the debut of Alzheimer's disease before 65 years of age to 55.3% in persons with vascular dementia and with increasing degrees of cognitive impairment. A wide range of personal characteristics, symptoms, signs, laboratory tests, and physical, psychological, and cognitive tests differed between fallers and non-fallers, most in disfavour of the fallers. Age, reduced Personal Activities of Daily Living, reduced gait speed, delayed recall, use of a walking aid, and depression were independent predictors of falls. : Among cognitively impaired persons with a history of falls, frailty was an independent predictor of falls. Neither the type of dementia nor the degree of cognitive impairment were independent predictors of falls. Prevention of frailty by physical training and social activity may be important in mitigating fall risk among older adults with impaired cognition.
认知功能受损的老年人和痴呆症患者的年跌倒发生率很高，跌倒造成的伤害对伤残调整生命年和公共卫生支出有不利影响。在这项基于登记处的研究中，我们在一大群认知障碍人群中探讨了跌倒发生率和跌倒者的特征。挪威认知症状评估登记处（NorCog）是一个拥有生物材料收集的国家研究和质量登记处。本研究纳入了登记处中9525名回答了跌倒相关问题的人。我们研究了跌倒发生率，并比较了跌倒者和未跌倒者的特征。年跌倒发生率为3774/9525（39.6%）。跌倒发生率因痴呆类型而异，65岁之前首次出现阿尔茨海默病的患者中为22.4%，血管性痴呆患者中为55.3%，且随着认知障碍程度的增加而升高。跌倒者和未跌倒者在广泛的个人特征、症状、体征、实验室检查以及身体、心理和认知测试方面存在差异，大多数情况对跌倒者不利。年龄、日常生活活动能力下降、步速减慢、回忆延迟、使用助行器和抑郁是跌倒的独立预测因素。在有跌倒史的认知障碍者中，虚弱是跌倒的独立预测因素。痴呆类型和认知障碍程度均不是跌倒的独立预测因素。通过体育锻炼和社交活动预防虚弱可能对降低认知受损老年人的跌倒风险很重要。
