Older women with diabetes have a higher risk of falls
Older women with diabetes have a higher risk of falls
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DOI：
10.2337/diacare.25.10.1749
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发表时间：
2002-10-01
期刊：
影响因子：
16.2
通讯作者：
Cummings, SR
中科院分区：
文献类型：
--
作者：
Schwartz, AV;Hillier, TA;Cummings, SR
目的：确定老年糖尿病女性跌倒的风险是否增加，以及已知的跌倒危险因素是否与任何增加的风险有关。研究设计和方法：这项前瞻性队列研究包括9,249名年龄大于或等于67岁的女性，这些女性登记在骨质疏松性骨折研究中。在基线时通过问卷调查来确定糖尿病。体能测试在第二次检查时进行。结果：共有629名女性(6.8%)患有糖尿病，其中99名使用胰岛素。在平均7.2年的时间里，1640名女性(18%)每年摔倒一次以上。按胰岛素使用情况分层的糖尿病与每年下降一次以上的风险增加相关(对于非胰岛素治疗的糖尿病，年龄调整的优势比[OR]1.68[95%可信区间1.37-2.07]；对于胰岛素治疗的糖尿病，年龄调整的OR 2.78[1.82-4.24])。在前两年的随访中，患有糖尿病的女性并不比没有糖尿病的女性更有可能摔倒(44%比42%；P=0.26)，但她们摔倒的次数更多(3.1vs.2.4；P<；0.01)。糖尿病女性更有可能有其他跌倒的危险因素，这似乎解释了与非胰岛素治疗的糖尿病相关的跌倒风险的增加(调整后的OR 1.18[0.87-1.60])，而不是胰岛素治疗的糖尿病(调整后的OR 2.76[1.52-5.01])。结论：老年糖尿病患者跌倒的风险增加，部分原因是已知跌倒危险因素的发生率增加，并可能受益于预防跌倒的干预措施。需要进一步的研究来确定糖尿病治疗是否可以降低跌倒的风险。
OBJECTIVE - To determine whether older women with diabetes have an increased risk of falls and whether known risk factors for falls account for any increased risk.RESEARCH DESIGN AND METHODS- This prospective cohort study included 9,249 women greater than or equal to67 years of age enrolled in the Study of Osteoporotic Fractures. Diabetes was determined by questionnaire at baseline. Physical performance was measured at the second examination. Subsequently, falls were ascertained every 4 months by postcard.RESULTS- A total of 629 (6.8%) women had diabetes, including 99 who used insulin. During an average of 7.2 years, 1,640 women (18%) fell more than once a year. Diabetes, stratified by insulin use, was associated with an increased risk of falling more than once a year (age-adjusted odds ratio [OR] 1.68 [95% CI 1.37-2.07] for non-insulin-treated diabetes; age-adjusted OR 2.78 [1.82-4.24] for insulin-treated diabetes). In the first 2 years of follow-up, women with diabetes were not more likely to fall than women without diabetes (44 vs. 42%; P = 0.26), but they had more falls (3.1 vs. 2.4; P < 0.01). Women with diabetes were more likely to have other risk factors for falls, which appeared to account for the increased risk of falls associated with non-insulin-treated diabetes (adjusted OR 1.18 [0.87-1.60]) but not insulin-treated diabetes (adjusted OR 2.76 [1.52-5.01]).CONCLUSIONS - Older women with diabetes have an increased risk of falling, partly because of the increased rates of known fall risk factors, and may benefit from interventions to prevent falls. Further research is needed to determine whether diabetes treatment reduces fall risk.