Increased postural sway during quiet stance as a risk factor for prospective falls in community-dwelling elderly individuals
Increased postural sway during quiet stance as a risk factor for prospective falls in community-dwelling elderly individuals
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DOI：
10.1093/ageing/afx083
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发表时间：
2017-11-01
期刊：
影响因子：
6.7
通讯作者：
Nordstrom, Peter
中科院分区：
文献类型：
--
作者：
Johansson, Jonas;Nordstrom, Anna;Nordstrom, Peter
目的：与跌倒有关的伤害构成老年人的主要健康风险，预计这些风险将随着人类寿命的延长而增加。姿势稳定性受损是与跌倒相关的潜在危险因素，尽管证据不确定，部分原因是缺乏前瞻性研究。本研究旨在探讨体位摇摆的客观测量如何预测意外跌倒。设计、环境和参与者：这项前瞻性观察性研究包括1877名70岁的社区居民，他们在2012年6月至2015年12月期间参加了健康老龄化计划。测量：使用Wii平衡板测量睁眼（EO）和闭眼（EC）试验期间的姿势摇摆。功能活动、肌肉力量、客观体力活动和认知表现也被测量。参与者在检查后6个月和12个月报告了事故。结果：在随访期间，255名（14%）潜在的跌倒者被确定。将压力中心（COP）摇摆长度划分为五分位数揭示了EO试验数据的非线性下降分布，而EC试验数据则没有。在对多个混杂因素进行调整后，在EO试验中，COP摇摆长度>= 400 mm的受试者跌倒风险增加了75%（优势比[OR] 1.75, 95%可信区间[CI] 1.09-2.79），在EC试验中，摇摆长度>= 920 mm的受试者跌倒风险增加了约一倍（OR 1.90, 95% CI 1.12-3.22）。结论：体位摇摆的客观测量可以独立预测老年社区居民的跌倒事件。需要进一步的研究来评估在临床环境中，体位摇摆长度是否对预测意外跌倒感兴趣。
Objective: fall-related injuries constitute major health risks in older individuals, and these risks are projected to increase in parallel with increasing human longevity. Impaired postural stability is a potential risk factor related to falls, although the evidence is inconclusive, partly due to the lack of prospective studies. This study aimed to investigate how objective measures of postural sway predict incident falls.Design, setting and participants: this prospectively observational study included 1,877 community-dwelling individuals aged 70 years who participated in the Healthy Ageing Initiative between June 2012 and December 2015.Measurements: postural sway was measured during eyes-open (EO) and eyes-closed (EC) trials using the Wii Balance Board. Functional mobility, muscle strength, objective physical activity and cognitive performance were also measured. Participants reported incident falls 6 and 12 months after the examination.Results: during follow-up, 255 (14%) prospective fallers were identified. Division of centre of pressure (COP) sway lengths into quintiles revealed a nonlinear distribution of falls for EO trial data, but not EC trial data. After adjustment for multiple confounders, fall risk was increased by 75% for participants with COP sway lengths >= 400 mm during the EO trial (odds ratio [OR] 1.75, 95% confidence interval [CI] 1.09-2.79), and approximately doubled for sway lengths >= 920 mm during the EC trial (OR 1.90, 95% CI 1.12-3.22).Conclusion: objective measures of postural sway independently predict incident falls in older community-dwelling men and women. Further studies are needed to evaluate whether postural sway length is of interest for the prediction of incident falls in clinical settings.