Northridge M E, Nevitt M C, Kelsey J L, Link B
Division of Epidemiology, Columbia University School of Public Health, New York, NY 10032, USA.
Am J Public Health. 1995 Apr;85(4):509-15. doi: 10.2105/ajph.85.4.509.
This study was undertaken to determine whether vigorous and frail older people who identify environmental hazards in their homes have an increased risk for falls.
A 1-year prospective study was conducted among 266 female and 59 male community-dwelling volunteers aged 60 to 93 years who had fallen at least once during the previous year. Composite measures of home safety and of frailty were derived using principal components analysis. Participants were divided into vigorous and frail groups, and associations between baseline home safety measures and falls at home over the follow-up year were compared between the two groups.
Frail individuals were more than twice as likely as vigorous individuals to fall during follow-up (rate ratio [RR] = 2.24; 95% confidence interval [CI] = 1.54, 3.27). In the study group as a whole, falls were not strongly associated with the presence of home hazards. However, when compared with vigorous older persons living with fewer home hazards, vigorous older persons living with more home hazards were more likely to fall. The increased risk for falls among vigorous elderly was limited to falls where home hazards were present. By contrast, living with more home hazards was not associated with increased likelihood of falls among frail older persons.
While frail older persons experience higher overall fall rates, vigorous older persons should not be overlooked in fall prevention projects.
本研究旨在确定在家中识别出环境危害的活力充沛和体弱的老年人跌倒风险是否增加。
对266名女性和59名男性社区居住志愿者进行了为期1年的前瞻性研究，这些志愿者年龄在60至93岁之间，且在前一年至少跌倒过一次。使用主成分分析法得出家庭安全和虚弱的综合测量指标。参与者被分为活力充沛组和体弱组，比较两组在随访年度中基线家庭安全措施与家中跌倒之间的关联。
在随访期间，体弱个体跌倒的可能性是活力充沛个体的两倍多（率比[RR]=2.24；95%置信区间[CI]=1.54，3.27）。在整个研究组中，跌倒与家庭危险的存在没有强烈关联。然而，与家中危险较少的活力充沛的老年人相比，家中危险较多的活力充沛的老年人更容易跌倒。活力充沛的老年人跌倒风险增加仅限于存在家庭危险的跌倒情况。相比之下，家中危险较多与体弱老年人跌倒可能性增加无关。
虽然体弱的老年人总体跌倒率较高，但在预防跌倒项目中也不应忽视活力充沛的老年人。
