北京市社区老年人跌倒的发生率及相关因素的随访研究  

The incidence of the fall and its risk factors in community-dwelling elderly people in Beijing： A follow-up study.

作　　者：石婧[1] 姚慧卿[1] 陶永康[2] 孟丽[1] 周白瑜[1] 段春波[1] 张传芳 覃朝晖[4] 孙振球[5] 于普林[1] 

机构地区：[1]北京医院老年医学研究所,100010 [2]北京中日友好医院急诊科,100029 [3]湖南省结核病防治所,长沙410013 [4]徐州医学院公共卫生学院,221002 [5]中南大学公共卫生学院,长沙410078

出　　处：《中华老年医学杂志》2016年第5期551-555,共5页Chinese Journal of Geriatrics

基　　金：中央保健科研课题，Rearch Fund for Health Care of Seniors

摘　　要：目的了解北京市社区老年人跌倒的发生率，并探讨老年人跌倒及再次跌倒的主要相关因素，为制定跌倒的防治策略提供科学依据。方法采用分层整群抽样的方法于2005年选取北京市东城区（原崇文区）龙潭街道办事处所管辖社区的60岁及以上的老年人进行基线调查，2009年在与基线调查相同的社区进行老年人跌倒的随访调查。调查方式均采用统一设计的老年人跌倒调查问卷，以面对面询问方式进行入户调查，对可能与跌倒有关的变量进行多因素Logistic回归分析跌倒及再次跌倒的相关因素。结果基线调查的1512例老年人中，跌倒发生率为18．0％（272／1512），其中女性跌倒发生率为20．1％（180／893），男性为14。9％（92／619），女性跌倒发生率高于男性（Х^2=7．45，P=0．006）；随访调查的472例老年人中，有84例跌倒，跌倒发生率为17．8％；基线调查跌倒者中抽取的170例老年人有49例随访时再次跌倒，再次跌倒的发生率为28．8％。多因素Logistic回归分析显示女性（OR=1．56）、家庭月收入高（OR=1．28）、独居（OR=1．68）、情绪常不稳定（OR=1．41）、担心跌倒（OR=1．72）、动态平衡异常（OR=1．50）、视力差（OR=1．24）、日常生活活动不能自理（OR=1．74）为老年人跌倒的危险因素；家庭月收入高（OR=2．17）、担心跌倒（OR=2．20）、独居（OR=4．67）是再次跌倒的危险因素，日常用品易于取放（OR=0．41）、过道或楼梯照明充足（0R一0．35）是再次跌倒的保护因素。结论北京市社区老年人跌倒及再次跌倒的发生率高，老年人跌倒是多种因素共同作用的结果，应采取有针对相关因素的综合性措施预防老年人跌倒。Objective To investigate the incidence of falls, and explore the risk factors for falls and subsequent falls in community-dwelling elderly people, in order to provide scientific basis for the prevention and treatment of falls. Methods A cross-sectional study was conducted in the Longtan community of Dongcheng district in Beijing in 2005. People aged 60 years and over were selected by stratified cluster sampling. A follow-up survey was conducted in the same community in 2009. Information about any falls during the past year was collected with a standardized structured questionnaire by face-to-face interview. Binary Logistic regression analysis was used to explore related factors for falls and subsequent falls in the elderly. Results Among 1512 interviewees at baseline, the incidence of falls was 18.0% （272/1512） during the past year, and the incidence of falls was higher in women than in men %20.1 % （180/893） vs. 14.9 % （92/619）,Х^2= 7.45, P = o. 0061. In follow-up survey, the incidence of falls among 472 interviewees was 17.8% （84/472） during the past 12 months. Among the 170 persons with a fall history in the baseline survey, 49 fell in 2009, with the incidence rate of subsequent falls in 28.8%. Multivariate logistic regression analysis showed that risk factors for fails were female （OR= 1.56）, higher family monthly income （OR = 1.28） , living alone （OR= 1.68）, emotional instability （OR= 1.41）, fear of falls （OR= 1.72）, abnormal dynamic balance （OR=1. 50）, impaired vision （OR= 1.24） and poor ability of daily life （OR=1. 74）. And risk factors for subsequent falls included higher family monthly income （OR=2. 17）, fear of fails （OR=2, 20） and living alone （OR= 4.67）, while protective factors for subsequent falls included easy access to daily necessities （OR=0.41） and good lighting in surrounding environment （OR=0.35）. Conclusions The incidences of fails and subsequent falls are higher in elderly community-dwellers in Beijing. Falls in the elderly

关 键 词：意外跌倒 发病率 危险因素 随访研究 

分 类 号：R592[医药卫生—老年医学]