Fear of Falling and Coexisting Sensory Difficulties As Predictors of Mobility Decline in Older Women
Fear of Falling and Coexisting Sensory Difficulties As Predictors of Mobility Decline in Older Women
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DOI：
10.1093/gerona/gls134
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发表时间：
2012-11-01
影响因子：
5.1
通讯作者：
Rantanen, Taina
中科院分区：
文献类型：
--
作者：
Viljanen, Anne;Kulmala, Jenni;Rantanen, Taina
活动能力下降、多种感觉障碍的并存和对跌倒的恐惧(FOF)都是老年人普遍关心的问题，然而，关于FOF和同时存在的感觉障碍对活动能力的联合影响的了解还很匮乏。我们收集了434名年龄在63-76岁的女性在基线和3年随访后的自述FOF、听力、视力、平衡和步行2公里方面的数据。使用Logistic回归模型进行分析。每名三分之一的参与者都报告在基线条件下行走2公里有困难。在横断面分析中，有FOF的人与没有FOF的人相比，行走2公里困难的优势比更高，且随着感觉困难数量的增加，优势增加。报告FOF且有三种感觉障碍的患者与报告无FOF且无感觉障碍的患者相比，行走困难的几率几乎是5倍(优势比=4.7，95%可信区间=1.9~11.7)。在290名基线上没有行走困难的女性中，54名参与者在3年的随访中出现了行走2公里的困难。有FOF且有2~3个感觉障碍的患者发生步行困难的优势比为3.5(95%可信区间=1.6~7.8)，与无FOF且基线时最多有一个感觉困难的患者相比，合并FOF的老年女性特别容易出现活动能力下降。当多种感觉障碍阻碍了对环境的准确信息的接收，导致步行能力加速下降时，由于FOF而导致的步行回避可能会得到加强。
Mobility decline, the coexistence of several sensory difficulties and fear of falling (FOF) are all common concerns in older people; however, knowledge about the combined effect of FOF and coexisting sensory difficulties on mobility is lacking.Data on self-reported FOF, difficulties in hearing, vision, balance, and walking 2 km were gathered with a structured questionnaire among 434 women aged 63-76 years at baseline and after a 3-year follow-up. Logistic regression models were used for analyses.Every third participant reported difficulties in walking 2 km at baseline. In cross-sectional analysis, the odds ratio for difficulties in walking 2 km was higher among persons who reported FOF compared with persons without FOF and the odds increased with the increasing number of sensory difficulties. Persons who reported FOF and who had three sensory difficulties had almost fivefold odds (odds ratio = 4.7, 95% confidence interval = 1.9-11.7) for walking difficulties compared with those who reported no FOF and no sensory difficulties. Among the 290 women without walking difficulties at baseline, 54 participants developed difficulty in walking 2 km during the 3-year follow-up. Odds ratio for incident walking difficulty was 3.5 (95% confidence interval = 1.6-7.8) in participants with FOF and with 2-3 sensory difficulties compared with persons without FOF and with at most one sensory difficulty at baseline.Older women who have several coexisting sensory difficulties combined with FOF are particularly vulnerable to mobility decline. Avoidance of walking as a result of FOF is likely to be reinforced when multiple sensory difficulties hinder reception of accurate information about the environment, resulting in accelerated decline in walking ability.