Fear of falling and restriction of mobility in elderly fallers
Fear of falling and restriction of mobility in elderly fallers
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DOI：
10.1093/ageing/26.3.189
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发表时间：
1997-05-01
期刊：
影响因子：
6.7
通讯作者：
Garry, PJ
中科院分区：
文献类型：
--
作者：
Vellas, BJ;Wayne, SJ;Garry, PJ
目的：确定老年人在经历跌倒后产生跌倒恐惧的特征，并调查这种恐惧与随着时间的推移健康状况变化的关系。设计：一项为期两年(1991-92)的跌倒前瞻性研究。从1990年到1993年，每个参与者每年都接受体检和主观健康评估。地点：美国新墨西哥州老龄化进程研究。研究对象：487名独立生活在社区中的老年人(60岁)。主要观察指标：经历过摔倒后对摔倒的恐惧。结果：219名在2年研究期间经历过摔倒的受试者中有70人(32%)报告有摔倒的恐惧。女性比男性更容易报告害怕摔倒(74%比26%)，害怕再次摔倒的人在1990年进入这项研究时有明显更多的平衡(31.9%比12.8%)和步态障碍(31.9%比7.4%)，在性别、年龄、心理状况、平衡和步态异常、经济资源和身体健康之间，Logistic回归分析显示步态异常和对身体健康、认知状况和经济资源的自我感觉差与跌倒恐惧显著相关。报告害怕摔倒的受试者随着时间的推移经历了更大的平衡(P=0.08)、步态(P<；0.01)和认知障碍(P=0.09)的增加，导致行动能力下降。结论：研究表明，大约三分之一的老年人在意外摔倒后会产生摔倒恐惧，这一问题应该在任何康复计划中得到专门解决。
Objectives: to identify the characteristics of elderly persons who develop a fear of falling after experiencing a fall and to investigate the association of this fear with changes in health status over time.Design: a prospective study of falls over a 2-year period (1991-92). Falls were ascertained using bimonthly postcards plus telephone interview with a standardized (World Health Organisation) questionnaire for circumstances, fear of falling and consequences of each reported fall, Each participant underwent a physical exam and subjective health assessment each year from 1990 to 1993.Setting: New-Mexico Aging Process Study, USA.Subjects: 487 elderly subjects (> 60 years) Living independently in the community.Main outcome measures: fear of falling after experiencing a fall.Results: 70 (32%) of 219 subjects who experienced a fall during the 2 year study period reported a fear of falling. Women were more likely than men to report fear of falling (74% vs 26%), Fallers who were afraid of falling again had significantly more balance (31.9% vs 12.8%) and gait disorders (31.9% vs 7.4%) at entry in the study in 1990, Among sex, age, mental status, balance and gait abnormalities, economic resource and physical health, logistic regression analysis show gait abnormalities and poor self-perception of physical health, cognitive status and economic resources to be significantly associated with fear of falling. Subjects who reported a fear of falling experienced a greater increase in balance (P = 0.08), gait (P < 0.01) and cognitive disorders (P = 0.09) over time, resulting in a decrease in mobility level.Conclusion: the study indicated that about one-third of elderly people develop a fear of falling after an incident fall and this issue should be specifically addressed in any rehabilitation programme.