Prospective study of the impact of fear of falling on activities of daily living, SF-36 scores, and nursing home admission
Prospective study of the impact of fear of falling on activities of daily living, SF-36 scores, and nursing home admission
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DOI：
10.1093/gerona/55.5.m299
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发表时间：
2000-05-01
影响因子：
5.1
通讯作者：
Szonyi, G
中科院分区：
文献类型：
--
作者：
Cumming, RG;Salkeld, G;Szonyi, G
背景本研究的目的是评估老年人害怕跌倒对健康的影响。从澳大利亚悉尼的两家医院共招募了528名受试者（平均年龄77岁），并随访了约12个月。85例受试者在随访期间死亡。31人入住养老机构。作为基线评估的一部分，对418名受试者成功实施了Tinetti福尔斯疗效量表（FES）。在具有基线FES评分的受试者中，在基线和随访时评估了307例受试者进行10项日常生活活动（ADL）的能力，并在基线和随访时评估了研究后期招募的90例受试者的SF-36评分。随访期间的福尔斯使用每月一次的福尔斯量表进行识别。与跌倒相关自我效能感高的人（FES评分= 100）相比，跌倒相关自我效能感低的人（FES评分小于或等于75）跌倒的风险增加（校正相对风险2.09。95%置信区间[CI] 1.31-3.33）。与跌倒相关的自我效能感较差的人进行ADL的能力下降更大（p < .001）：FES评分较低（小于或等于75）的人的ADL总分下降了0.69，但FES评分为100的人的ADL总分仅下降了0.04。ADL的下降没有解释; FES评分低的人中福尔斯的频率较高。SF-36评分（特别是身体功能和身体疼痛子量表的评分）在与跌倒相关的自我效能感差的人中下降得更多。那些说他们害怕跌倒的非跌倒者进入老年护理机构的风险增加。梨的掉落对老年人有严重的后果。成功地减少对跌倒的恐惧和提高与跌倒相关的自我效能的干预措施可能对健康有重大益处。
Background The aim of this study was to assess the impact of Fear of falling on the health of older people.Methods. A total of 528 subjects (mean age 77 years) were recruited from two hospitals in Sydney, Australia, and followed for approximately 12 months. Eighty-five subjects died during follow-up. and 31 were admitted to an aged care institution. Tinetti's Falls Efficacy Scale (FES) was successfully administered to 418 subjects as part of the baseline assessment. Among those with baseline FES scores, ability to perform 10 activities of daily living (ADLs) was assessed at baseline and Follow-up in 307 subjects, and SF-36 scores were assessed at baseline and follow-up in 90 subjects recruited during the latter part of the study. Falls during follow-up were identified using a monthly falls calendar.Results. Compared with those with a high fall-related self-efficacy (FES score = 100), those with a low fall-related self-efficacy (FES score less than or equal to 75) had an increased risk of falling (adjusted relative risk 2.09. 95% confidence interval [CI] 1.31-3.33). Those with poorer fall-related self-efficacy had greater declines in ability to perform ADLs (p < .001): the total ADL score decreased by 0.69 activities among persons with low FES scores (less than or equal to 75) but decreased by only 0.04 activities among persons with FES scores of 100. Decline in ADLs was not explained; by the higher frequency of falls among persons with low FES scores. SF-36 scores (particularly scores on the Physical Function and Bodily Pain subscales) tended to decline more among persons with poor Fall-related self-efficacy. Nonfallers who said they were afraid of falling had an increased risk of admission to an aged care institution.Conclusions. Pear of falling has serious consequences for older people. Interventions that successfully reduce fear of falling and improve fall-related self-efficacy are likely to have major health benefits.