Engel-Yeger Batya, Zilbershlag Yael
Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel.
Department of Occupational Therapy, Faculty of Health Allied Professions, Ono Academic College, Kiryat Ono, Israel.
Br J Occup Ther. 2022 Sep;85(9):685-693. doi: 10.1177/03080226211072769. Epub 2022 May 25.
The present study aimed to identify signs of frequent fall-related body dysfunction (depression/cognition) as exhibited in daily activities among older adults. The role of fall risk in mediating body dysfunction and daily activities was also explored.
Participants included 123 non-institutionalised older adults. Depression and cognitive status were measured by the Geriatric Depression Scale (GDS-15) and the Montreal Cognitive Assessment (MoCA). Fall risk was determined by a questionnaire, supported by the Time Up and Go test (TUG). Executive functions (EF) were assessed by the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) and the Alternate Executive Function Performance Test medication management performance-based assessment. Daily life measures included the Barthel and Instrumental scale of activities of daily living, and World Health Organization Quality of Life questionnaire.
Based on a falls risk score, 39 out of 123 participants (32%) were high-risk fallers. High-risk fallers showed greater body dysfunction, as recognised in daily activities. Structural equation modelling (SEM) revealed that fall risk mediated the associations among depression, executive dysfunction and daily activities.
Emotional and cognitive dysfunctions that affect people with high fall risk may manifest while older people perform daily activities. Community fall prevention programmes should screen for such fall-related dysfunction and provide strategies to minimise falls and enhance daily function.
本研究旨在识别老年人日常活动中频繁出现的与跌倒相关的身体功能障碍(抑郁/认知)迹象。还探讨了跌倒风险在介导身体功能障碍和日常活动中的作用。
参与者包括123名非机构化老年人。采用老年抑郁量表(GDS-15)和蒙特利尔认知评估量表(MoCA)测量抑郁和认知状态。通过问卷调查确定跌倒风险,并辅以起立行走测试(TUG)。采用成人版执行功能行为评定量表(BRIEF-A)和基于药物管理表现的替代执行功能测试评估执行功能(EF)。日常生活测量包括巴氏指数和日常生活活动能力量表以及世界卫生组织生活质量问卷。
根据跌倒风险评分,123名参与者中有39名(32%)为高跌倒风险者。高跌倒风险者在日常活动中表现出更大的身体功能障碍。结构方程模型(SEM)显示,跌倒风险介导了抑郁、执行功能障碍和日常活动之间的关联。
影响高跌倒风险人群的情绪和认知功能障碍可能在老年人进行日常活动时显现出来。社区跌倒预防计划应筛查此类与跌倒相关的功能障碍,并提供策略以尽量减少跌倒并增强日常功能。