Effects of Falling on the Quality of Life of Old-old People

本研究以北海道0镇871名65岁及以上居民为研究对象，探讨跌倒对老年人后续跌倒恐惧、身心健康及日常生活之影响。进行了两次调查：一次是基线调查(1998年)，871名受试者中有754人参加；另一次是对599名在基线调查中回答从未跌倒的受试者的后续调查(1999年)。在跟踪调查中，599名入选对象中有518人参与。这些调查是由训练有素的采访者在受试者家中进行的。调查的项目包括性别、年龄、过去一年跌倒的历史和跌倒的情况、对跌倒的恐惧、自我效能感、疾病史、自评健康状况、生活满意度、工具性日常生活能力、社会角色、社会网络和生活方式。在基线调查中，发现更多的女性在过去一年中经历过跌倒…高于男性(19.3%的男性和21.6%的女性)。使用助行器的人以及有高血压、白内障或骨质疏松症病史的人跌倒的次数更多。在参与跟踪调查的518名受试者中，68人回答说他们经历过跌倒，452人回答说他们自基线调查以来没有摔倒过。对这两组人进行比较，以评估跌倒对生活质量的影响。与“不坠落”组相比，“坠落”组对坠落的恐惧有所增加。自评健康状况和生活满意度在跌倒组下降，反之，在跌倒组上升。与跌倒组相比，不跌倒组的受试者人数、社会角色得分和社会参与得分显著下降。结果表明，老年人跌倒的经历不仅增加了对再次跌倒的焦虑程度，而且导致主观幸福感恶化，限制了社会角色和与他人的交往。然而，结果并不支持跌倒对老年人生活质量有更大影响的假设。较少

The purpose of this study was to examine the effects of falling on the subsequent fear of falling, physical and emotional health, and daily life of elderly people.The subjects were 871 residents of 0 Town in Hokkaido who were aged 65 years or older. Two surveys were carried out: a baseline survey (in 1998) in which 754 of the 871 subjects participated and a follow-up survey (in 1999) of 599 subjects who replied in the baseline survey that they had never experienced a fall. In the follow-up survey, 518 of the 599 selected subjects participated. The surveys were conducted in the homes of the subjects by a trained interviewers. The items surveyed included gender, age, history of falls in the past year and the circumstances of the falls, fear of falling, self efficacy, history of disease, self-rated health status, satisfaction with life, instrumental ADL, social roles, social network, and lifestyle.In the baseline survey, it was found that more women had experienced falls in the past year … More than men had (19.3% of the men vs 21.6% of the women). People who used a walking aid as well as people with a history of hypertension, cataract or osteoporosis experienced more falls.Of the 518 subjects who participated in the follow-up survey, 68 replied that they had experienced falls and 452 replied that they had not experienced falls since the time of the baseline survey. These two groups were compared to assess the effects of falls on quality of life. The fear of falling had increased in the "fall" group compared to that in the "nonfall" group. The self-rated health status and degree of satisfaction with life had decreased in the fall group and, conversely, had increased in the nonfall group. The number of people with whom subjects associated, the social role score, and the social participation score had notably decreased in the nonfall group compared to those in the fall group.The results suggest that experience of falling by elderly people not only increases the degree of anxiety about falling again but also causes a deterioration of subjective well-being as well as limitations to social roles and association with other people. However, the results did not support the hypothesis that falling has a stronger effect on the quality of life of old-old people. Less