A screening tool with five risk factors was developed for fall-risk prediction in community-dwelling elderly
A screening tool with five risk factors was developed for fall-risk prediction in community-dwelling elderly
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DOI：
10.1016/j.jclinepi.2010.12.014
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发表时间：
2011-10-01
影响因子：
7.2
通讯作者：
Colvez, Alain
中科院分区：
文献类型：
--
作者：
Bongue, Bienvenu;Dupre, Caroline;Colvez, Alain
目的：为社区居住的老年人开发一种简单的临床筛查工具。 研究设计和设置：对 65 岁及以上的健康受试者进行了一项前瞻性多中心队列研究，在法国健康保险的 10 个健康检查中心进行了检查。在 12 个月的随访中，每月通过电话确定跌倒情况。使用 Cox 回归模型进行多变量分析。将最终模型中预测变量的回归系数相加以获得总分。使用曲线下面积 (AUC) 评估辨别力。结果：纳入了 759 名受试者。平均年龄为 70.7 岁，其中 51% 为女性。 563 名（32%）参与者中至少发生过一次跌倒事件。性别、独居、精神药物使用、骨关节炎、跌倒史以及单腿平衡 (OLB) 测试期间手臂位置的变化是最强的预测因素。这些预测因子用于建立风险评分。分数的 AUC 为 0.70。以 4.90 中的 1.68 为分界点，阳性预测值和阴性预测值分别为 72.0% 和 72.7%。 结论：具有 5 个危险因素的筛查工具和 OLB 测试可以预测健康社区老年人的跌倒。 (C) 2011 Elsevier Inc. 保留所有权利。
Objective: To develop a simple clinical screening tool for community-dwelling older adults.Study Design and Setting: A prospective multicenter cohort study was performed among healthy subjects of 65 years and older, examined in 10 health examination centers for the French health insurance. Falls were ascertained monthly by telephone for 12-month follow-up. Multivariate analyses using Cox regression models were performed. Regression coefficients of the predictors in the final model were added up to obtain the total score. The discriminative power was assessed using the area under the curve (AUC).Results: Thousand seven hundred fifty-nine subjects were included. The mean age was 70.7 years and 51% were women. At least one fall occurred among 563 (32%) participants. Gender, living alone, psychoactive drug use, osteoarthritis, previous falls, and a change in the position of the arms during the one-leg balance (OLB) test were the strongest predictors. These predictors were used to build a risk score. The AUC of the score was 0.70. For a cutoff point of 1.68 in a total of 4.90, the positive predictive value and negative predictive value were 72.0% and 72.7%, respectively.Conclusion: A screening tool with five risk factors and the OLB test could predict falls in healthy community-dwelling older adults. (C) 2011 Elsevier Inc. All rights reserved.