SHARED RISK-FACTORS FOR FALLS, INCONTINENCE, AND FUNCTIONAL DEPENDENCE - UNIFYING THE APPROACH TO GERIATRIC SYNDROMES
SHARED RISK-FACTORS FOR FALLS, INCONTINENCE, AND FUNCTIONAL DEPENDENCE - UNIFYING THE APPROACH TO GERIATRIC SYNDROMES
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DOI：
10.1001/jama.273.17.1348
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发表时间：
1995-05-03
影响因子：
120.7
通讯作者：
DOUCETTE, JT
中科院分区：
文献类型：
--
作者：
TINETTI, ME;INOUYE, SK;DOUCETTE, JT
目的：-确定是否可以确定一组代表多个区域的损害的因素，这些因素容易导致跌倒、大小便失禁和功能依赖。设计-基于人群的队列，并进行为期1年的随访。设置。-普通社区。参与者。-共有927名72岁及以上的康涅狄格州纽黑文居民完成了基线和1年的访谈。主要结果衡量。-每周至少一次尿失禁发作，在随访一年中至少两次摔倒，并依赖于人类帮助进行一种或多种基本的日常生活活动。结果：至少一年，据报道，16%的参与者出现了尿失禁，至少两次下降了10%，20%的参与者出现了功能依赖。导致大小便失禁、跌倒和功能依赖的四个独立易感因素包括：椅子站立时间缓慢(下肢受损)、手臂力量下降(上肢受损)、视力和听力下降(感觉受损)、焦虑或抑郁得分较高(情感受损)。随着这些诱因数量的增加，大小便失禁、跌倒和功能依赖的发生率都有显著增加。例如，经历功能依赖的参与者的比例翻了一番(7%到14%，28%到60%)(chi(2)=119.8；P
Objective.-To determine whether a set of factors representing impairments in multiple areas could be identified that predisposes to falling, incontinence, and functional dependence.Design.-Population-based cohort with a 1-year follow-up.Setting.-General community.Participants.-A total of 927 New Haven, Conn, residents, aged 72 years and older who completed the baseline and 1-year interviews.Main Outcome Measures.-At least one episode of urinary incontinence per week, at least two falls during the follow-up year, and dependence on human help for one or more basic activities of daily living.Results.-At 1 year, urinary incontinence was reported by 16%, at least two falls by 10%, and functional dependence by 20% of participants. The four independent predisposing factors for the outcomes of incontinence, falling, and functional dependence included slow timed chair stands (lower extremity impairment), decreased arm strength (upper extremity impairment), decreased vision and hearing (sensory impairment), and either a high anxiety or depression score (affective impairment). There was a significant increase in each of incontinence, falling, and functional dependence as the number of these predisposing factors increased. For example, the proportion of participants experiencing functional dependence doubled (7% to 14% to 28% to 60%) (chi(2)=119.8; P