Zhou Yuanjin, Meyer Kylie, Irani Ellliane, Liu Xiao, Choi Namkee
University of Texas at Austin, Steve Hicks School of Social Work, Austin, Texas, USA.
Case Western Reserve University, Frances Payne Bolton School of Nursing, Cleveland, OH, USA.
J Am Geriatr Soc. 2025 Jun;73(6):1808-1818. doi: 10.1111/jgs.19442. Epub 2025 Mar 24.
We aim to investigate the associations between 2-year fall status among community-dwelling older people with dementia and care partners' emotional, physical, and financial difficulties, with living arrangements (co-residence vs. separate residence) as a moderator.
We used the 2015-2017 National Health and Aging Trends Study and the linked survey 2017 National Study of Caregiving (935 care partners for 567 community-dwelling older people with dementia). We employed multilevel generalized linear regression models to examine the associations of fall status between 2015 and 2017 with caregiving difficulties in 2017 for co-residing and non-co-residing care partners. We then evaluated the moderation effect of care partners' living arrangements.
For co-residing care partners, high (p = 0.001), increased (p = 0.001), and decreased (p = 0.001) fall frequency over 2 years was significantly associated with emotional difficulties. For non-co-residing care partners, high (p < 0.001), increased (p = 0.001), and decreased (p = 0.002) fall frequency was significantly associated with their physical difficulties. Compared to co-residing care partners, those who lived apart experienced greater physical difficulties when the fall frequency increased over 2 years (p < 0.05), but this effect became non-significant after the Bonferroni correction. High fall frequency was significantly associated with financial difficulties for co-residing (p = 0.009) and non-co-residing (p = 0.003) care partners, and decreased fall frequency was only significantly associated with financial difficulties for non-co-residing care partners (p = 0.018). All findings for financial difficulties became non-significant after the Bonferroni correction.
This study found differential associations between fall status over 2 years and care-related difficulties by care partners' living arrangements. Preventing falls for this population can potentially reduce the informal caregiving burden, especially the emotional difficulties for co-residing care partners and the physical difficulties of non-co-residing caregivers. Tailored interventions to manage fall risk among older people with dementia and support care partners with different living arrangements are crucial to improving their well-being.
我们旨在调查社区居住的老年痴呆患者两年内的跌倒状况与护理伙伴的情感、身体和经济困难之间的关联，并以居住安排（同住与分开居住）作为调节因素。
我们使用了2015 - 2017年国家健康与老龄化趋势研究以及相关联的2017年全国护理研究调查（针对567名社区居住的老年痴呆患者的935名护理伙伴）。我们采用多水平广义线性回归模型来检验2015年至2017年期间跌倒状况与2017年同住和不同住护理伙伴的护理困难之间的关联。然后，我们评估了护理伙伴居住安排的调节作用。
对于同住的护理伙伴，两年内跌倒频率高（p = 0.001）、增加（p = 0.001）和减少（p = 0.001）与情感困难显著相关。对于不同住的护理伙伴，跌倒频率高（p < 0.001）、增加（p = 0.001）和减少（p = 0.002）与他们的身体困难显著相关。与同住的护理伙伴相比，那些分开居住的人在两年内跌倒频率增加时经历了更大的身体困难（p < 0.05），但在进行Bonferroni校正后，这种影响变得不显著。跌倒频率高与同住（p = 0.009）和不同住（p = 0.003）护理伙伴的经济困难显著相关，而跌倒频率降低仅与不同住护理伙伴的经济困难显著相关（p = 0.018）。在进行Bonferroni校正后，所有关于经济困难的结果都变得不显著。
本研究发现，根据护理伙伴的居住安排，两年内的跌倒状况与护理相关困难之间存在不同的关联。预防这一人群跌倒可能会减轻非正式护理负担，特别是减轻同住护理伙伴的情感困难和不同住护理人员的身体困难。针对老年痴呆患者的跌倒风险进行量身定制的干预措施，并为不同居住安排的护理伙伴提供支持，对于改善他们的福祉至关重要。
