认知、恐惧与跌倒：社区居住老年人平衡功能受损的心理预测因素

Cognition, fear, and falls: psychological predictors of balance impairment in community-dwelling older adults.

作者信息

Alkhamis Batool Abdulelah, Elrefaey Basant Hamdy, Almohiza Mohammad A, Alahmari Khalid A, Alshahrani Mastour Saeed, Alnakhli Hani Hassan, Koura Ghada, Mukherjee Debjani, Kardm Saleh M, Alyazedi Faisal M, Reddy Ravi Shankar

机构信息

Program of Physical Therapy, Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia.

Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.

出版信息

Front Psychiatry. 2025 Jun 3;16:1610894. doi: 10.3389/fpsyt.2025.1610894. eCollection 2025.

DOI:10.3389/fpsyt.2025.1610894

PMID:40530055

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12170642/

Abstract

OBJECTIVE

This study aimed to (1) assess the associations among cognitive function, fear of falling, and balance in community-dwelling older adults; (2) identify key predictors of balance performance; and (3) examine implications for fall prevention strategies.

METHODS

Eighty-four older adults (≥65 years) residing independently in the community were recruited during outpatient visits. Cognitive function was assessed using the Saint Louis University Mental Status (SLUMS), fear of falling was measured with the Falls Efficacy Scale-International (FES-I), and balance performance was evaluated using the Berg Balance Scale (BBS). Physical activity, demographic factors, and fall history were also recorded.

RESULTS

Bivariate correlations showed that higher cognitive function was associated with better balance (r = 0.45, p = 0.014), while greater fear of falling was linked to poorer balance (r = -0.52, p = 0.003). A hierarchical regression model revealed that cognitive function (β = 0.32, p = 0.002) and fear of falling (β = -0.44, p < 0.001) were significant predictors of balance performance, even after controlling for age, gender, physical activity, and fall history. Exploratory logistic regression showed that fear of falling (OR = 1.12, p = 0.002) and balance performance (OR = 0.91, p = 0.008) were significant predictors of fall history.

CONCLUSION

Cognitive function and fear of falling are independent and meaningful predictors of balance performance in older adults. These findings support the integration of cognitive and psychological assessments into exercise-based fall prevention strategies.

摘要

目的

本研究旨在（1）评估社区居住的老年人认知功能、跌倒恐惧与平衡能力之间的关联；（2）确定平衡能力表现的关键预测因素；（3）探讨对跌倒预防策略的启示。

方法

在门诊就诊期间招募了84名独立居住在社区的老年人（≥65岁）。使用圣路易斯大学精神状态检查表（SLUMS）评估认知功能，用国际跌倒效能量表（FES-I）测量跌倒恐惧，并用伯格平衡量表（BBS）评估平衡能力表现。还记录了身体活动、人口统计学因素和跌倒史。

结果

双变量相关性分析显示，较高的认知功能与较好的平衡能力相关（r = 0.45，p = 0.014），而更大的跌倒恐惧与较差的平衡能力相关（r = -0.52，p = 0.003）。分层回归模型显示，即使在控制了年龄、性别、身体活动和跌倒史之后，认知功能（β = 0.32，p = 0.002）和跌倒恐惧（β = -0.44，p < 0.001）仍是平衡能力表现的重要预测因素。探索性逻辑回归显示，跌倒恐惧（OR = 1.12，p = 0.002）和平衡能力表现（OR = 0.91，p = 0.008）是跌倒史的重要预测因素。