Foot Disorders and Falls in a Population-Based Cohort

描述(由申请人提供)：尽管临床印象中足部疾病是老年人跌倒和不良事件的常见原因，但几乎没有基于人群的数据支持这一观点。足部疾病往往被忽视为跌倒的重要潜在原因，很少有研究评估重要的中介因素，如老年人的平衡或步态。跌倒和足部疾病都是主要的公共卫生问题，随着人口老龄化，这些问题的重要性只会增加。我们建议研究特定足部疾病对跌倒的影响，并进一步评估平衡或步态是否影响这种关系。我们将把对足部疾病的全面评估与在两年内观察到的跌倒以及可能改变这种关系的观察到的身体表现、平衡和步态测量联系起来。我们这个项目的三个具体目标将研究1)足部疾病和跌倒之间的纵向关系，2)脚部疾病和跌倒之间的纵向关系，考虑通过平衡不良的途径，3)足部疾病和跌倒，考虑通过步态受损的途径，以及次要目标探索鞋和跌倒之间的关系。 检查干预变量或中介具有重要意义，因为它们可以澄清足部疾病和跌倒之间关系的性质，也因为它们是未来干预的潜在目标。没有其他队列将老年人足部疾病的详细信息与全面的纵向跌倒信息联系起来，到目前为止，也没有研究检查平衡、步态或鞋类在足部疾病和跌倒的人群评估中的作用。这项拟议的研究将提供与老龄化领域临床医学和公共卫生密切相关的重要信息。研究结果将帮助我们设计未来的干预措施，如足部护理、鞋子和特定设备，以降低老年人跌倒的风险。该项目将广泛利用已经资助的计划项目赠款的招聘资源和数据收集(首席调查员：L.Lipsitz，赠款#AG04390，7/01/04-06/30/08，“HRCA/哈佛研究型养老院”)。基于初步数据，这项研究将在两年的随访中提供关于足部疾病对老年男性和女性新跌倒的作用的新的和重要的信息。对老年人足部疾病的更多了解可能会导致更好地理解预防跌倒的策略。

DESCRIPTION (provided by applicant): Despite the clinical impression that foot disorders are a common cause of falls and adverse events in older persons, little population-based data exist to support this view. Foot disorders are often overlooked as significant potential causes of falls and little work has evaluated significant mediators, such as balance or gait in older persons. Both falls and foot disorders represent major public health problems that will only increase in importance as the population ages. We propose to examine the impact of specific foot disorders upon falls, and further to evaluate whether balance or gait affect this relation. We will link a comprehensive assessment of foot disorders to observed falls over a two-year follow-up, as well as to the observed physical performance, balance and gait measures that might modify the relation. Our 3 specific aims of this project will examine the longitudinal relations between 1) foot disorders and falls, 2) foot disorders and falls considering a pathway via poor balance, 3) foot disorders and falls, considering a pathway via impaired gait, and a secondary aim exploring the relation between footwear and falls. It is significant to examine intervening variables, or mediators, as they may clarify the nature of the relation between foot disorders and falls, and also since they are potential targets for future interventions. No other cohort has linked detailed information on foot disorders in elders to comprehensive longitudinal falls information and no study thus far, has examined the roles of balance, gait, or footwear in an population evaluation of foot disorders and falls. The proposed study will provide essential information on associations of keen interest both to clinical medicine and public health in 'he field of aging. Results will help us to design future interventions, such as foot care, shoes and specific devices to reduce the risk of falls among elderly people. This project will make extensive use of the recruitment resources and data collection from an already funded program project grant (Principal Investigator: L. Lipsitz, Grant # AG04390, 7/01/04 - 06/30/08, "HRCA/Harvard Research Nursing Home"). Based on preliminary data, this study will provide new and significant information about the role of foot disorders upon new falls in elderly men and women over a two-year follow-up. A greater understanding of foot disorders in older individuals may lead to better understanding of the strategies to prevent falls.