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内在能力在老年人平衡能力及跌倒情况中的中介作用。

The mediating role of intrinsic capacity in balance and falls among older adults.

作者信息

Cui Yao, Zhou Jian, Liu Qian, Ye Hui, Liu Bo

机构信息

Department of Geriatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China.

Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China.

出版信息

Sci Rep. 2025 Apr 5;15(1):11732. doi: 10.1038/s41598-025-96081-9.

Abstract

The intrinsic capacity (IC) and balance function of older adults are closely related to falls. IC is not only directly related to falls but may also play a mediating role in balance and falls. This study aims to explore the mediating role of IC in balance and falls. A total of 284 elderly patients were divided into fall group (n = 131) and non-fall group (n = 153) based on whether they had experienced falls. All patients underwent assessments of IC, including locomotion (SPPB), vitality (MNA-SF), sensory (self-reported vision/hearing), cognition (MOCA), and psychological status (SAS/SDS). Patients underwent the sensory organization test and limits of stability test. (1) Using fall history as a binary dependent variable and various balance indicators as independent variables, visual (VIS) (p = 0.011, OR 0.957), vestibular function (p < 0.001, OR 0.958), and direction control (p = 0.042, OR 0.967) were negatively associated with falls. (2) After incorporating IC scores, sensory function (p < 0.001, OR 0.154), SPPB (p = 0.003, OR 0.758), and SOT-Composite (p < 0.001, OR 0.900) were negatively associated with falls, while SAS (p = 0.008, OR 1.068) was positively associated with falls. (3) IC score mediated the relationship between movement velocity (MVL) and falls. Among the five dimensions of IC, the SPPB and the MNA-SF mediated the relationship between MVL and falls, and the SPPB mediated the relationship between maximum excursion (MXE) and falls. The SAS mediated the relationship between SOM, VIS and falls, while the SDS mediated the relationship between SOM, EPE and falls. There are multiple mediating effects of IC between balance function and falls.

摘要

老年人的内在能力(IC)和平衡功能与跌倒密切相关。IC不仅与跌倒直接相关,还可能在平衡和跌倒中起中介作用。本研究旨在探讨IC在平衡和跌倒中的中介作用。根据是否经历过跌倒,将284例老年患者分为跌倒组(n = 131)和非跌倒组(n = 153)。所有患者均接受了IC评估,包括运动能力(SPPB)、活力(MNA-SF)、感觉功能(自我报告的视力/听力)、认知能力(MOCA)和心理状态(SAS/SDS)。患者接受了感觉组织测试和稳定性极限测试。(1)以跌倒史作为二元因变量,各种平衡指标作为自变量,视觉功能(VIS)(p = 0.011,OR 0.957)、前庭功能(p < 0.001,OR 0.958)和方向控制(p = 0.042,OR 0.967)与跌倒呈负相关。(2)纳入IC评分后,感觉功能(p < 0.001,OR 0.154)、SPPB(p = 0.003,OR 0.758)和SOT-综合评分(p < 0.001,OR 0.900)与跌倒呈负相关,而SAS(p = 0.008,OR 1.068)与跌倒呈正相关。(3)IC评分介导了运动速度(MVL)与跌倒之间的关系。在IC的五个维度中,SPPB和MNA-SF介导了MVL与跌倒之间的关系,SPPB介导了最大偏移(MXE)与跌倒之间的关系。SAS介导了SOM、VIS与跌倒之间的关系,而SDS介导了SOM、EPE与跌倒之间的关系。IC在平衡功能和跌倒之间存在多种中介作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fd7/11972392/46249c5df991/41598_2025_96081_Fig1_HTML.jpg

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