老年男性人群跌倒发生率及相关危险因素的现况调查

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摘要目的系统评估老年男性人群跌倒发生情况,调查与跌倒相关的危险因素。方法在60岁以上老年男性群体中开展调查,评价指标包括受试者一般信息、跌倒史、生活习惯、病史、体检信息、运动能力、肌肉力量、步行能力、平衡能力、认知状态等,研究老年人跌倒发生风险因素及相关损伤情况,根据1年内跌倒史分为跌倒组与非跌倒组,比较两组间各项指标差异,通过单因素与多因素二元logistic回归分析,探索其相关因素。结果完成调查520名,平均(77.21±9.70)岁,近1年内跌倒发生率31.35%;既往跌倒损伤率33.6%,既往跌倒失能发生率31.9%。跌倒高危时间为清晨与深夜,地点是卧室、卫生间,跌倒多在行走中发生,跌倒方式主要为滑倒与绊倒。环境原因主要是地面湿滑、障碍物,个人原因复杂。跌倒组(163名)与非跌倒组(357名)在年龄、日常生活活动能力(ADL)、工具性日常生活活动(IADL)量表、简易精神状态检查表、下肢肌力、单腿平衡(SLBT)、计时“起立-行走”试验、5次坐立试验、步速、功能性步行量表、运动史及多病状态上有差异。单因素Logistic回归分析显示,老年男性人群跌倒发生的危险因素有高龄、IADL功能差、多病状态,以及脑卒中、体位性低血压、消化疾病、肌骨疾病、听觉损失等多种疾病,保护因素有运动史、ADL、认知功能、下肢肌力、SLBT、行走能力等。多因素Logistic回归显示,老年男性人群跌倒的危险因素有高龄(OR=1.085,95%CI:1.026～1.147)、脑卒中(OR=2.528,95%CI:1.118～5.717)、体位性低血压(OR=2.845,95%CI:1.249～6.481),保护因素有良好的ADL(OR=0.944,95%CI:0.931～0.959)、下肢力量(OR=0.842,95%CI:0.784～0.905)、SLBT(OR=0.705,95%CI:0.633～0.786)。结论老年男性人群的跌倒发生率较高,跌倒风险随年龄增加而升高,跌倒后易发生损伤、失能。跌倒与自身原因、时间、环境有关,高龄、日常生活能力水平低、下肢力量与平衡能力下降及有脑卒中、体位性低血压病史的老年男性跌倒风险更高。

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	安慧妍
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	张丽

关键词 ：跌倒, 老年, 男性, 横断面研究, 患病率, 危险因素

Abstract：Objective To systematically evaluate the incidence of falls in elderly male and investigate the risk factors associated with falls. Methods A study was carried out on men over 60 years old. The general information, history of falls, living habits, medical history, physical examination information, exercise ability, muscle strength, walking ability, balance ability, cognitive status, and other indicators were collected to study the risk factors and related injuries of falls in the elderly. According to the history of falls within one year, the subjects were divided into a fall group and a non-fall group. The differences between the two groups were compared, and the relevant factors were explored by univariate and multivariate logistic regression analysis. Results A total of 520 older subjects were surveyed, with an average age of (77.21±9.70)years. The incidence of falls in the past year was 31.35%. The injury rate of previous falls was 33.6% and the incidence of disability was 31.9%. The highest risk time of falls was early in the morning and late night, and the highest risk places were bedrooms and bathrooms. Most falls occurred during walking, and the main ways of falling were slipping and tripping. The main reasons were slippery ground, obstacles, and complex personal causes. There were significant differences between fall group (n=163) and non-fall group (n=357) in age, activity of daily living (ADL), instrumental activity of daily living (IADL), minimum mental state examination, muscle strength of lower limbs, single leg balance test (SLBT), timed “up and go” test, five-time sit-stand test, gait speed, functional ambulation category scale, exercise history and multimorbidity state. Univariate logistic regression analysis showed that the risk factors for falls in elderly men were advanced age, poor function of IADL, stroke, orthostatic hypotension, digestive disorder, musculoskeletal disorder, hearing loss, and other diseases, and the protective factors included exercise history, ADL, cognitive function, muscle strength of the lower limb, SLBT, and walking ability and so on. Multivariate logistic regression showed that advanced age(OR=1.085, 95%CI:1.026~1.147), stroke (OR=2.528, 95%CI:1.118~5.717), and orthostatic hypotension (OR=2.845, 95%CI:1.249~6.481) were the risk factors for falls in the elderly men, and good ability in ADL (OR=0.944, 95%CI:0.931~0.959), lower limb strength (OR=0.842, 95%CI:0.784~0.905), and SLBT (OR=0.705, 95%CI:0.633~0.786) were the protective factors. Conclusions The incidence of falls in senile males is high, and the risk of fall increases with the increase of age. Injury and disability are common after falls. The related factors include self-reasons, time and environment. Elderly men with low level of ADL ability, insufficient strength of lower limb, poor balance ability, a history of stroke and orthostatic hypotension has a higher risk of falls.

Key words： fall elderly male cross-sectional study prevalence rate risk factors

收稿日期: 2024-01-02

ZTFLH:

R592

基金资助:国家老年疾病临床研究中心项目(NCRCG-PLAGH-2023007);首都卫生发展科研专项课题(首发2024-2-5031);山东省重点研发计划项目(2022SFGC0601)

通讯作者: 张丽,E-mail: zhangli781230@163.com

作者简介: 安慧妍,硕士,医师。

引用本文:

安慧妍, 瓮长水, 蒋天裕, 刘淼, 张丽. 老年男性人群跌倒发生率及相关危险因素的现况调查[J]. 武警医学, 2024, 35(5): 410-416. AN Huiyan, WENG Changshui, JIANG Tianyu, LIU Miao, ZHANG Li. Prevalence survey on incidence of falls and related risk factors in elderly males. Med. J. Chin. Peop. Armed Poli. Forc., 2024, 35(5): 410-416.

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http://journal08.magtechjournal.com/Jwk_wjyx/CN/ 或 http://journal08.magtechjournal.com/Jwk_wjyx/CN/Y2024/V35/I5/410

[1]	World Health Organization. Falls[EB/OL]. (2021-04-26) [2023-12-13]. https://www.who.int/zh/news-room/fact-sheets/detail/falls.
[1]	World Health Organization. Falls[EB/OL]. (2021-04-26) [2023-12-13]. https://www.who.int/zh/news-room/fact-sheets/detail/falls.
[2]	齐士格,王志会,王丽敏,等.2013年中国老年居民跌倒伤害流行状况分析[J].中华流行病学杂志,2018,39(4):439-442.
[2]	齐士格,王志会,王丽敏,等.2013年中国老年居民跌倒伤害流行状况分析[J].中华流行病学杂志,2018,39(4):439-442.
[3]	张迪,何耀,刘淼,等.北京市农村社区老年人跌倒情况调查及影响因素研究[J].中华流行病学杂志,2016,37(5):624-628.
[3]	张迪,何耀,刘淼,等.北京市农村社区老年人跌倒情况调查及影响因素研究[J].中华流行病学杂志,2016,37(5):624-628.
[4]	Smith A A, Silva A O, Rodrigues R A, et al. Assessment of risk of falls in elderly living at home[J]. Rev Lat Am Enfermagem,2017, 25: e2754.
[4]	Smith A A, Silva A O, Rodrigues R A, et al. Assessment of risk of falls in elderly living at home[J]. Rev Lat Am Enfermagem,2017, 25: e2754.
[5]	Bentur N, King Y.The challenge of validating SF-12 for its use with community-dwelling elderly in Israel[J]. Qual Life Res,2010,19(1): 91-95.
[5]	Bentur N, King Y.The challenge of validating SF-12 for its use with community-dwelling elderly in Israel[J]. Qual Life Res,2010,19(1): 91-95.
[6]	Kwakkel G, Veerbeek J M, Wel H V D, et al. Diagnostic accuracy of the Barthel index for measuring activities of daily living outcome after ischemic hemispheric stroke: does early poststroke timing of assessment matter?[J]. Stroke,2011,42(2):342-346.
[6]	Kwakkel G, Veerbeek J M, Wel H V D, et al. Diagnostic accuracy of the Barthel index for measuring activities of daily living outcome after ischemic hemispheric stroke: does early poststroke timing of assessment matter?[J]. Stroke,2011,42(2):342-346.
[7]	Zhang L, Ding Z H, Qiu L Y, et al. Falls and risk factors of falls for urban and rural community-dwelling older adults in China[J]. BMC Geriatr, 2019, 19(1):379.
[7]	Zhang L, Ding Z H, Qiu L Y, et al. Falls and risk factors of falls for urban and rural community-dwelling older adults in China[J]. BMC Geriatr, 2019, 19(1):379.
[8]	Moreland B, Kakara R, Henry A. Trends in nonfatal falls and fall-related injuries among adults aged≥65 years-United States, 2012-2018[J]. MMWR Morb Mortal Wkly Rep, 2020,69(27):875-881.
[8]	Moreland B, Kakara R, Henry A. Trends in nonfatal falls and fall-related injuries among adults aged≥65 years-United States, 2012-2018[J]. MMWR Morb Mortal Wkly Rep, 2020,69(27):875-881.
[9]	Jiang Y, Xia Q H, Zhou P, et al. Falls and fall-related consequences among older people living in long-term care facilities in a megacity of China[J]. Gerontology, 2020,66(6):523-531.
[9]	Jiang Y, Xia Q H, Zhou P, et al. Falls and fall-related consequences among older people living in long-term care facilities in a megacity of China[J]. Gerontology, 2020,66(6):523-531.
[10]	李佳琏,祝贵明,颜豪森,等.老年人跌倒状况及影响因素的调查分析[J].中国老年保健医学,2021,19(6):78-83.
[10]	李佳琏,祝贵明,颜豪森,等.老年人跌倒状况及影响因素的调查分析[J].中国老年保健医学,2021,19(6):78-83.
[11]	吴圆荣,曾森枚,叶景云,等.广东省乡镇居家老人跌倒现状及危险因素调查分析[J].上海护理,2021,21(7):38-42.
[11]	吴圆荣,曾森枚,叶景云,等.广东省乡镇居家老人跌倒现状及危险因素调查分析[J].上海护理,2021,21(7):38-42.
[12]	Tornero-Quiñones I, Sáez-Padilla J, Espina D A, et al. Functional ability, frailty and risk of falls in the elderly: relations with autonomy in daily living[J]. Int J Environ Res Public Health, 2020, 17(3):1006.
[12]	Tornero-Quiñones I, Sáez-Padilla J, Espina D A, et al. Functional ability, frailty and risk of falls in the elderly: relations with autonomy in daily living[J]. Int J Environ Res Public Health, 2020, 17(3):1006.
[13]	Dipietro L, Campbell W W, Buchner D M, et al. Physical activity, injurious falls, and physical function in aging: an umbrella review[J]. Med Sci Sports Exerc, 2019,51(6): 1303-1313.
[13]	Dipietro L, Campbell W W, Buchner D M, et al. Physical activity, injurious falls, and physical function in aging: an umbrella review[J]. Med Sci Sports Exerc, 2019,51(6): 1303-1313.
[14]	Ganz D A, Latham N K.Prevention of falls in community-dwelling older adults[J].N Engl J Med,2020, 382(8): 734-743.
[14]	Ganz D A, Latham N K.Prevention of falls in community-dwelling older adults[J].N Engl J Med,2020, 382(8): 734-743.
[15]	Mol A, Slangen L, Trappenburg M C, et al. Blood pressure drop rate after standing up is associated with frailty and number of falls in geriatric outpatients[J]. J Am Heart Assoc, 2020, 9(7): e014688.
[15]	Mol A, Slangen L, Trappenburg M C, et al. Blood pressure drop rate after standing up is associated with frailty and number of falls in geriatric outpatients[J]. J Am Heart Assoc, 2020, 9(7): e014688.
[16]	Zhang H P, Zhao Y S, Wei F, et al. Prevalence and risk factors for fall among rural elderly: a county-based cross-sectional survey[J]. Int J Clin Pract, 2022:8042915.
[16]	Zhang H P, Zhao Y S, Wei F, et al. Prevalence and risk factors for fall among rural elderly: a county-based cross-sectional survey[J]. Int J Clin Pract, 2022:8042915.
[17]	Çinarli T, Koç Z. Fear and risk of falling, activities of daily living, and quality of life: assessment when older adults receive emergency department care[J]. Nurs Res,2017,66(4):330-335.
[17]	Çinarli T, Koç Z. Fear and risk of falling, activities of daily living, and quality of life: assessment when older adults receive emergency department care[J]. Nurs Res,2017,66(4):330-335.
[18]	Duarte G P, Santos J, Lebrão M L, et al. Relationship of falls among the elderly and frailty components[J]. Rev Bras Epidemiol, 2019, 21(Suppl 2): e180017.
[18]	Duarte G P, Santos J, Lebrão M L, et al. Relationship of falls among the elderly and frailty components[J]. Rev Bras Epidemiol, 2019, 21(Suppl 2): e180017.
[19]	Qin Z, Baccaglini L. Distribution, determinants, and prevention of falls among the elderly in the 2011-2012 California health interview survey[J]. Public Health Rep, 2016, 131(2): 331-339.
[19]	Qin Z, Baccaglini L. Distribution, determinants, and prevention of falls among the elderly in the 2011-2012 California health interview survey[J]. Public Health Rep, 2016, 131(2): 331-339.
[20]	Pérez-Ros P,Martínez-Arnau F M,Tarazona-Santabalbina F J. Risk factors and number of falls as determinants of quality of life of community-dwelling older adults[J]. J Geriatr Phys Ther, 2019, 42(2): 63-72.
[20]	Pérez-Ros P,Martínez-Arnau F M,Tarazona-Santabalbina F J. Risk factors and number of falls as determinants of quality of life of community-dwelling older adults[J]. J Geriatr Phys Ther, 2019, 42(2): 63-72.
[21]	Pérez-Ros P, Vila-Candel R, Martínez-Arnau F M. A home-based exercise program focused on proprioception to reduce falls in frail and pre-frail community-dwelling older adults[J]. GeriatrNurs, 2020, 41(4): 436-444.
[21]	Pérez-Ros P, Vila-Candel R, Martínez-Arnau F M. A home-based exercise program focused on proprioception to reduce falls in frail and pre-frail community-dwelling older adults[J]. GeriatrNurs, 2020, 41(4): 436-444.
[22]	Jallouli S, Ben Dhia I, Sakka S, et al.Combined effect of gender differences and fatiguing task on postural balance, functional mobility and fall risk in adults with multiple sclerosis: a preliminary study[J]. Neurol Res, 2022,44(12):1074-1085.
[22]	Jallouli S, Ben Dhia I, Sakka S, et al.Combined effect of gender differences and fatiguing task on postural balance, functional mobility and fall risk in adults with multiple sclerosis: a preliminary study[J]. Neurol Res, 2022,44(12):1074-1085.
[23]	于普林,高超,周白瑜,等.预防老年人肌少症核心信息中国专家共识(2021)[J].中华老年医学杂志,2021,40(8):953-954.
[23]	于普林,高超,周白瑜,等.预防老年人肌少症核心信息中国专家共识(2021)[J].中华老年医学杂志,2021,40(8):953-954.
[24]	Chen L K, Woo J, Assantachai P, et al. Asian Working Group for sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment[J]. J Am Med Dir Assoc, 2020,21(3):300-307.
[24]	Chen L K, Woo J, Assantachai P, et al. Asian Working Group for sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment[J]. J Am Med Dir Assoc, 2020,21(3):300-307.
[25]	Asian Working Group for sarcopenia.Sarcopenia in Asia:consensus report of the Asian Working Group for sarcopenia[J].J Am Med Dir Assoc,2014,15(2):95-101.
[25]	Asian Working Group for sarcopenia.Sarcopenia in Asia:consensus report of the Asian Working Group for sarcopenia[J].J Am Med Dir Assoc,2014,15(2):95-101.
[26]	Nogueira P A D, Nascimento D C, Stone W, et al. Muscle quality is associated with history of falls in octogenarians[J]. J Nutr Health Aging, 2021, 25(1): 120-125.
[26]	Nogueira P A D, Nascimento D C, Stone W, et al. Muscle quality is associated with history of falls in octogenarians[J]. J Nutr Health Aging, 2021, 25(1): 120-125.
[27]	Inoue T, Kamijo K, Haraguchi K, et al. Risk factors for falls in terms of attention during gait in community-dwelling older adults[J]. GeriatrGerontol Int, 2018, 18(8): 1267-1271.
[27]	Inoue T, Kamijo K, Haraguchi K, et al. Risk factors for falls in terms of attention during gait in community-dwelling older adults[J]. GeriatrGerontol Int, 2018, 18(8): 1267-1271.
[28]	Kyrdalen I L, Thingstad P, Sandvik L, et al. Associations between gait speed and well-known fall risk factors among community-dwelling older adults[J]. Physiother Res Int, 2019: e1743.
[28]	Kyrdalen I L, Thingstad P, Sandvik L, et al. Associations between gait speed and well-known fall risk factors among community-dwelling older adults[J]. Physiother Res Int, 2019: e1743.
[29]	Srivastava S, Muhammad T. Prevalence and risk factors of fall-related injury among older adults in India: evidence from a cross-sectional observational study[J]. BMC Public Health,2022,22(1): 550.
[29]	Srivastava S, Muhammad T. Prevalence and risk factors of fall-related injury among older adults in India: evidence from a cross-sectional observational study[J]. BMC Public Health,2022,22(1): 550.
[30]	Geerse D J, Roerdink M, Marinus J, et al. Walking adaptability for targeted fall-risk assessments[J]. Gait Posture,2019,70:203-210.
[30]	Geerse D J, Roerdink M, Marinus J, et al. Walking adaptability for targeted fall-risk assessments[J]. Gait Posture,2019,70:203-210.
[31]	黎娜楠,王燕娇.老年脑卒中住院患者跌倒影响因素研究进展[J].中国医学创新,2023,20(24):169-172.
[31]	黎娜楠,王燕娇.老年脑卒中住院患者跌倒影响因素研究进展[J].中国医学创新,2023,20(24):169-172.
[32]	Jehu D A, Davis J C, Falck R S, et al. Risk factors for recurrent falls in older adults: a systematic review with meta-analysis[J]. Maturitas,2021,144:23-28.
[32]	Jehu D A, Davis J C, Falck R S, et al. Risk factors for recurrent falls in older adults: a systematic review with meta-analysis[J]. Maturitas,2021,144:23-28.
[33]	李静,余茜.成都市社区脑卒中后遗症期患者跌倒情况调查及相关因素分析[J].中国康复医学杂志,2020,35(1):69-72.
[34]	何蕾,柴双双,冯宝玉,等.脑卒中后下肢痉挛患者行发散式体外冲击波治疗对改善平衡及姿势控制能力的效果[J].武警医学,2023,34(7):582-585.
[35]	陈洪艳,李海燕,张然,等.腹带干预对老年患者餐后低血压的预防作用[J].武警医学,2023,34(5):377-379+383.
[33]	李静,余茜.成都市社区脑卒中后遗症期患者跌倒情况调查及相关因素分析[J].中国康复医学杂志,2020,35(1):69-72.
[34]	何蕾,柴双双,冯宝玉,等.脑卒中后下肢痉挛患者行发散式体外冲击波治疗对改善平衡及姿势控制能力的效果[J].武警医学,2023,34(7):582-585.
[35]	陈洪艳,李海燕,张然,等.腹带干预对老年患者餐后低血压的预防作用[J].武警医学,2023,34(5):377-379+383.
[36]	Chen X D, He L X, Shi K W, et al. Age-stratified modifiable fall risk factors in Chinese community-dwelling older adults[J]. Arch GerontolGeriatr,2023,108:104922.
[36]	Chen X D, He L X, Shi K W, et al. Age-stratified modifiable fall risk factors in Chinese community-dwelling older adults[J]. Arch GerontolGeriatr,2023,108:104922.