Hansen Pernille, Nygaard H, Schultz M, Dela F, Aagaard P, Ryg Jesper, Suetta C
Geriatric Research Unit, Department of Medicine, Copenhagen University Hospital, Herlev and Gentofte, Gentofte, Denmark.
Geriatric Research Unit, Department of Geriatric and Palliative Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark.
Eur Geriatr Med. 2025 May 27. doi: 10.1007/s41999-025-01239-3.
To identify differences in characteristics between mobility-limited older adults with a history of falls and those at risk of falling but who have not yet fallen.
Frailty and muscle strength were characteristics distinguishing between older adults with a history of falls and those absent of falls despite an increased risk of falling.
Frailty should be incorporated alongside handgrip strength (HGS) and sit-to-stand (STS) tests into routine evaluations of mobility-limited older adults referred for fall assessment.
We aimed to identify differences in characteristics between mobility-limited older adults with a history of falls and those at risk of falling, and to identify the parameter with the strongest predictive value on the risk of falling.
Data included anthropometry, HGS, 30-s and 5-reps STS tests, maximal isometric knee extensor strength, gait speed (6 m), postural balance (tandem test), and muscle mass (BIA). Frailty was assessed using the Clinical Frailty Scale (CFS) and sarcopenia was evaluated according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) guidelines. Outcomes of falls (past year), and depression (Geriatric Depression Scale 15) were self-reported.
Totally, 505 mobility-limited older adults (mean age 79.7 ± 6.3 years, 64.8% females) were included. Of these, 400 (79.2%) had experienced one or more falls within the past year (fallers), while 105 (20.8%) had not experienced a fall (at risk). Patients with experienced falls were more likely to feel depressed, had reduced handgrip strength, and reduced performance in both STS tests compared to those who had not fallen. Frailty was the strongest individual parameter associated with a history of prior falls, even after adjusting for covariates such as depression and 30-s STS (aOR 3.80; 95% CI 1.70-8.50).
Present study identified frailty as a key factor independently associated with a history of falls in this population. Additionally, handgrip strength and STS performance were key characteristics distinguishing between older adults with a history of falls within the past 12 months and those at risk of falling.
NCT05795556.
确定有跌倒史的行动受限老年人与有跌倒风险但尚未跌倒的老年人在特征上的差异。
虚弱和肌肉力量是区分有跌倒史的老年人与虽有跌倒风险但未跌倒的老年人的特征。
在对因跌倒评估而转诊的行动受限老年人进行常规评估时，应将虚弱与握力（HGS）和坐立试验（STS）一起纳入评估。
我们旨在确定有跌倒史的行动受限老年人与有跌倒风险的老年人在特征上的差异，并确定对跌倒风险预测价值最强的参数。
数据包括人体测量学、HGS、30秒和5次重复的STS试验、最大等长膝关节伸肌力量、步速（6米）、姿势平衡（串联试验）和肌肉量（生物电阻抗分析）。使用临床虚弱量表（CFS）评估虚弱程度，并根据欧洲老年人肌肉减少症工作组2（EWGSOP2）指南评估肌肉减少症。跌倒（过去一年）和抑郁（老年抑郁量表15项）的结果通过自我报告获得。
总共纳入了505名行动受限的老年人（平均年龄79.7±6.3岁，64.8%为女性）。其中，400人（79.2%）在过去一年中经历过一次或多次跌倒（跌倒者），而105人（20.8%）未经历过跌倒（有风险者）。与未跌倒的患者相比，有跌倒经历的患者更容易感到抑郁，握力降低，并且在两项STS试验中的表现也较差。即使在调整了抑郁和30秒STS等协变量后，虚弱仍是与既往跌倒史相关的最强个体参数（调整后比值比3.80；95%置信区间1.70 - 8.50）。
本研究确定虚弱是该人群中与跌倒史独立相关的关键因素。此外，握力和STS表现是区分过去12个月内有跌倒史的老年人与有跌倒风险的老年人的关键特征。
NCT05795556。
