Kawamura Koki, Iwase Taku, Ishino Shota, Nakao Yuto, Kagaya Hitoshi, Akatsu Hiroyasu, Arai Hidenori
Department of Rehabilitation, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi, 474-8511, Japan.
Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.
Eur Geriatr Med. 2025 May 21. doi: 10.1007/s41999-025-01233-9.
Falls in older adults increase the risk of mortality and hospitalization, particularly when physical function is low. This study aimed to determine whether low physical function and muscle mass, are also valuable for predicting falls within one year in older patients who visited an outpatient clinic for frailty.
This prospective cohort study analyzed the registry data of 624 outpatients aged > 65 years (mean age: 77.9 ± 6.0 years; female 368, male 256). The endpoint was the incidence of falls within one year. These included the five-chair standing test (5CS), usual gait speed, short physical performance battery, handgrip strength, and skeletal muscle mass index. All of these tests were performed during the first clinic appointment. The question about fall history was asked one year after the examination, and the history of falls during the period of one year from the date of the examination. We analyzed the relationship between whether these assessments were below the cutoff values and falls within one year using multiple logistic regression analysis.
A total of 154 (25%) patients fell within one year. Those with a low result on the 5CS or usual gait speed had significantly higher rates of falls within one year, even after adjustment for covariates, with odds ratios [95% confidence interval] of 2.07 [1.37-3.13] and 1.68 [1.09-2.60], respectively.
Low physical function, particularly in the lower limbs, was associated with near-term fall risk. The 5CS is helpful in fall risk assessment.
老年人跌倒会增加死亡和住院风险，尤其是在身体功能较差时。本研究旨在确定身体功能低下和肌肉量减少对于预测前往门诊就诊的老年衰弱患者在一年内发生跌倒是否也具有重要价值。
这项前瞻性队列研究分析了624名年龄大于65岁的门诊患者（平均年龄：77.9±6.0岁；女性368名，男性256名）的登记数据。终点指标是一年内跌倒的发生率。这些指标包括五椅起立试验（5CS）、日常步态速度、简短体能状况量表、握力和骨骼肌质量指数。所有这些测试均在首次门诊就诊时进行。在检查一年后询问跌倒史，以及自检查日期起一年内的跌倒史。我们使用多因素逻辑回归分析来分析这些评估结果是否低于临界值与一年内跌倒之间的关系。
共有154名（25%）患者在一年内跌倒。5CS结果或日常步态速度较低的患者，即使在对协变量进行调整后，一年内跌倒的发生率仍显著较高，优势比[95%置信区间]分别为2.07[1.37 - 3.13]和1.68[1.09 - 2.60]。
身体功能低下，尤其是下肢功能，与近期跌倒风险相关。5CS有助于跌倒风险评估。
