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北京市社区老年人群跌倒发生率、影响因素及结局研究

Incidence, risk factors, and outcomes of falls among elderly in Beijing communities

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收录情况: ◇ 统计源期刊 ◇ 北大核心 ◇ 卓越:领军期刊 ◇ 中华系列

机构: [1]首都医科大学宣武医院循证医学中心,北京 100053 [2]北京老年医院老年医学科,北京 100096 [3]首都医科大学宣武医院神经内科,北京 100053 [4]北京老年医院老年健康与医 养结合研究所,北京 100095
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关键词: 老年人  跌倒  发生率  危险因素  死亡率

摘要:
Objective: To investigate the incidence, risk factors, and outcomes of falls among the elderly community population in Beijing. Methods: A cross-sectional survey was conducted using stratified multistage random sampling to select urban and rural residents aged 65 years and older in Beijing. Mortality data was collected after the baseline survey for 5 years. The incidence of falls was weighted based on the composition ratios of age and gender from the 2010 Nation-wide Population Census of Beijing. A logistic regression model was used to analyze the impacts of demographic sociology of common chronic diseases on fall occurrence. The Cox proportional hazards regression model was used to analyze the fall and 5-year survival association. Results: A total of 2 968 participants completed the questionnaire, at cross-sectional survey, with an average age of (73.2±6.0) years, and 1 581 (53.8%) participants were female. Three hundred and sixty-one individuals experienced a fall within the past year. Among those who fell, 64 (17.7%) fell twice, and 95 (26.6%) fell three or more times. Of them, 14.4% (52) had post-fall fractures, with the wrist, knee, and hip being the most common fracture sites, accounting for 25.0%, 17.3%, and 15.4%, respectively. The weighted fall incidence was 12.4% (95%CI: 11.2%-13.5%). Aging, being female, and living in rural areas were more likely to fall. Logistic regression analysis showed that after adjusting for age, gender, and urban-rural status, the risk of falls for those living alone (OR=1.48, 95%CI: 1.08-2.04) or living with children/grandchildren (OR=1.51, 95%CI: 1.15-1.97) were significantly higher than those living with their spouse. In addition, the risk of falls was elevated significantly among the elderly with hypertension, diabetes, stroke, dementia, depression status, urinary incontinence, arthritis, insomnia, vision, and hearing loss, dependence on activities of daily living (ADL), general and poor self-rated health (SRH). The Cox proportional hazard regression model revealed that the 5-year risk of death increased by 65% (HR=1.65, 95%CI: 1.29-2.11) for those who experienced a fall, which increased with fall frequency. This elevated risk persisted after adjusting for chronic conditions, ADL, and SRH. Conclusions: Ageing, female, living in rural regions, having common chronic diseases, dependence on ADL, general and poor SRH, living alone or living with children/grandchildren were associated with the elevated fall risk. The occurrence of fall was seasonal. The most common short-term adverse consequence after a fall was fractures, while the long-term effect was an increased risk of death.

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第一作者机构: [1]首都医科大学宣武医院循证医学中心,北京 100053
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