Himmelmann Laura, Stuckenschneider Tim, Kwiecien Robert, Zieschang Tania
Department for Health Services Research, Geriatric Medicine/ School of Medicine and Health Services, Carl von Ossietzky University Oldenburg, Lower Saxony, Ammerländer Heerstraße 140, 26129, Oldenburg, Germany.
Institute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany.
BMC Geriatr. 2025 May 29;25(1):385. doi: 10.1186/s12877-025-06032-2.
Severe falls in older individuals are a leading cause of emergency department (ED) visits and often result in long-term impairments that reduce physical activity (PA). Limited information exists on the characteristics of individuals who suffer from physical inactivity after such falls and the factors that influence it. This study investigates the association between potential moderators and changes in PA in older adults six months after a severe fall.
Participants were recruited from the SeFallED study (German Clinical Trials Register ID: 00025949). Moderators were evaluated through a home-based geriatric assessment conducted within four weeks of a severe fall with presentation to the ED. PA was quantified using both sensor-based (n = 72 men (75 years), n = 106 women (74 years) and self-reported (n = 105 men (74 years), n = 174 women (73 years) assessments. A Linear Mixed Model was used for analysis.
Sensor-based PA revealed a significant time effect for step count (p = 0.006), indicating an increase in PA six months after a severe fall. Fall history (95% CI: -1,009.5 - (-207.4), p = 0.003) and age (95% CI: -315.8 - (-82.5), p < 0.01) were significant negative moderators for changes in PA, only in women. No significant changes in self-reported PA were observed after six months (p = 0.109).
Participants showed an increase in sensor-based PA six months after a severe fall, though this was negatively associated with age and fall history. Early identification of factors that affect PA recovery may help stratify individuals by risk and target those in need of secondary prevention.
DRKS (Deutsches Register für klinische Studien, DRKS0 00259 49). Prospectively registered on 4th November, 2021.
老年人严重跌倒急诊就诊的主要原因,且常导致长期功能障碍,进而降低身体活动(PA)水平。关于跌倒后出现身体活动不足的个体特征及其影响因素的信息有限。本研究调查了严重跌倒六个月后,老年人群中潜在调节因素与身体活动变化之间的关联。
参与者来自SeFallED研究(德国临床试验注册编号:00025949)。在严重跌倒并前往急诊科就诊后四周内,通过居家老年评估对调节因素进行评估。身体活动通过基于传感器(男性72人(75岁),女性106人(74岁))和自我报告(男性105人(74岁),女性174人(73岁))两种方式进行量化评估。采用线性混合模型进行分析。
基于传感器的身体活动显示步数有显著的时间效应(p = 0.006),表明严重跌倒六个月后身体活动增加。仅在女性中,跌倒史(95% CI:-1,009.5 - (-207.4),p = 0.003)和年龄(95% CI:-315.8 - (-82.5),p < 0.01)是身体活动变化的显著负调节因素。六个月后自我报告的身体活动未观察到显著变化(p = 0.109)
严重跌倒六个月后,参与者基于传感器的身体活动增加,尽管这与年龄和跌倒史呈负相关。早期识别影响身体活动恢复的因素,可能有助于按风险对个体进行分层,并针对需要二级预防的人群。
DRKS(德国临床研究注册中心,DRKS0 00259 49)。于2021年11月4日进行前瞻性注册。