Factors predicting fractures during falling impacts among home-dwelling older adults
Factors predicting fractures during falling impacts among home-dwelling older adults
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DOI：
10.1111/j.1532-5415.1997.tb02928.x
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发表时间：
1997-11-01
影响因子：
6.3
通讯作者：
Kivela, SL
中科院分区：
文献类型：
--
作者：
Luukinen, H;Koski, K;Kivela, SL
目的：为了探讨骨折的预测因素，在下降的影响在家庭居住的老年adults.Design：一个前瞻性的，以人口为基础的survey.SETTING病例对照研究：在北方芬兰的五个农村城市。本研究的病例是在4年随访期内发生骨折的病例，在分析中使用首次骨折（n = 82）。对照组（n = 82）中选择的人谁遭受软组织损伤;匹配的年龄，性别和位置的第一次受伤的periods.MEASUREMENTS：在4年的随访期间，所有的人口福尔斯下降记录使用秋天的日记，电话采访，和医疗记录的信息。根据既往福尔斯跌倒的次数和严重程度、福尔斯跌倒的环境和地点、病史、药物使用、症状、临床检查和试验、营养状况、功能能力以及社会和健康行为确定4年随访期间骨折的危险因素。对分类变量进行交叉表分析，对连续变量的均值进行配对t检验，并进行条件Logistic回归分析。根据双变量分析，福尔斯导致骨折的危险因素是经常害怕摔倒，异常的跟胫试验，膝关节伸展力量降低，握力降低，远视力差，仰卧位脉率低，不能负重5公斤100米，不能从事室外重体力劳动，不能经常锻炼。有限的社会参与与压裂呈负相关。条件Logistic回归分析显示，经常害怕跌倒是导致福尔斯的危险因素（OR 2.50; CI 1.11-5.65），膝关节伸展强度降低（OR 3.38; CI 1.00-11.4），远视力差（OR 3.45; CI 1.13-10.6），而有限的社会参与（OR 0.23; CI 0.11-0.79）保护骨折的发生。结论：知觉、肌肉力量、心理和社会功能受损可能会影响伤害性坠落冲击期间的骨折风险。需要更大样本量的研究来证实这一点，并检查通过这些风险因素导致福尔斯跌倒期间骨折风险的情况和机制。
OBJECTIVE: To investigate the predictors of fractures during falling impacts among home-dwelling older adults.DESIGN: A case-control study within a prospective, population-based survey.SETTING: Five rural municipalities in northern Finland.PARTICIPANTS: The study population consisted of all home-dwelling persons aged 70 or older living in these five municipalities (n = 790 (85%)). The cases for this study were those with fracture, using the first fracture (n = 82) in the analyses, during a follow-up period of 4 years. Controls (n = 82) were selected from among the persons who suffered soft tissue injuries; matching was by age, sex, and location of the first injury during the period.MEASUREMENTS: During a 4-year follow-up period, all falls in the population were recorded using fall diaries, telephone interviews, and information from medical records. Risk factors for fractures during the 4-year follow-up were determined according to the number and severity of previous falls, circumstances and place of falls, disease history, use of medicines, symptoms, clinical examinations and tests, nutritional status, functional abilities and social and health behavior. Cross-tabulations for categorial variables, paired t tests for the means of continuous variables, and conditional logistic regression analysis were performed.RESULTS: According to the bivariate analyses, the risk factors for falls resulting in a fracture were frequent fear of falling, abnormal heel-shin test, reduced knee extension strength, reduced grip strength, poor distance visual acuity, low supine pulse rate, inability to carry a 5-kg load 100 meters, not doing heavy outdoor work, and no habitual exercise. A limited amount of social participation was associated negatively with fracturing. Conditional logistic regression analysis showed that the risk factors for fracture-causing falls were frequent fear of falling (OR 2.50; CI 1.11-5.65), reduced knee extension strength (OR 3.38; CI 1.00-11.4), and poor distance visual acuity (OR 3.45; CI 1.13-10.6), whereas limited social participation (OR 0.23; CI 0.11-0.79) protected against the occurrence of fractures.CONCLUSION: Impaired perception, muscle strength, and psychological and social functioning may influence fracture risk during injurious fall impacts. Studies with larger sample sizes are needed to confirm this and to examine the circumstances and mechanisms contributing to the fracture risk during falls via these risk factors.