社区高龄老年人步速、握力与跌倒风险的相关性研究  

Study on the association between gait speed,grip strength and the risk of falls among the oldest old in community

作　　者：申姜琼[1] 王晓媛[1] 徐伟豪 孟文文[3] SHEN Jiangqiong;WANG Xiaoyuan;XU Weihao;MENG Wenwen(Department of Nursing,the Second Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Deparment of Vasculocardiology,the Second Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Medical Service Office,Medical District of North Beijing,Chinese PLA General Hospital,Beijing 100094,China)

机构地区：[1]解放军总医院第二医学中心护理部,北京100853 [2]解放军总医院第二医学中心心血管内科,北京100853 [3]解放军总医院京北医疗区卫勤办,北京100094

出　　处：《中国医药导报》2020年第14期146-149,共4页China Medical Herald

基　　金：军委后勤保障部卫生局面上项目(18BJZ24)。

摘　　要：目的探究社区高龄老年人步速、握力与跌倒风险的关系。方法采用中国健康与养老追踪调查前瞻性队列研究数据库中2013年的数据,选择年龄≥80岁,进行步速和握力测量,同时有跌倒数据的研究对象,研究共纳入497例社区老年人,以结局是否发生跌倒进行分组,其中跌倒组为122例,未跌倒组为375例。采用logistic回归模型分析步速、握力与跌倒风险之间的关系。结果回访的24个月内,122例(25.4%)发生了跌倒事件。对年龄、性别、高脂血症等进行多因素校正后显示,低步速(RR=2.57,95%CI:1.29~5.14)是跌倒的独立危险因素。对步速和握力进行组合后分析发现,正常步速合并低握力(RR=1.95,95%CI:1.12~3.42)或正常握力合并低步速(RR=2.82,95%CI:1.49~5.34)的研究对象发生跌倒的风险较高,低步速合并低握力的研究对象发生跌倒的风险最高(RR=3.14,95%CI:1.41~7.00)。结论步速和握力可以独立或联合预测社区高龄老年人跌倒的发生,将步速和握力的测量纳入社区高龄老年人跌倒风险评估中,可能会提高跌倒风险预测的准确性。Objective To explore the association between gait speed,grip strength and the risk of falls among the oldest old in communities.Methods Data of the China Health and Retirement Longitudinal Study in 2013 was collected,subjects aged≥80 years,who had measured their gait speed and grip strength,and who had fall data were selected.A total of 497 elderly people in communities were included in the study and divided into two groups based on whether they fell or not:122 elderly people in the fall group and 375 elderly people in the non-fall group.Association between gait speed,grip strength and risk of falls was examined with logistic regression models.Results In 24 months of follow-up,25.4%of study participants(n=122)experienced a fall.After adjusting for age,gender,and hyperlipidemia,it was found that low gait speed(RR=2.57,95%CI:1.29-5.14)was independently associated with a higher risk of falls.After analyzing the combination of gait speed and grip strength,it was found that participants with normal gait speed combined with low grip strength(RR=1.95,95%CI:1.12-3.42)or with normal grip strength combined with low gait speed(RR=2.82,95%CI:1.49-5.34)had a higher risk of fall,participants with both low gait speed and low grip strength had highest risk of fall(RR=3.14,95%CI:1.41-7.00).Conclusion Gait speed and grip strength can predict future falls independently and jointly,taking the measurement of gait speed and grip strength into the fall risk assessment of the oldest old in the community may improve the accuracy of fall risk prediction.

关 键 词：高龄老年 社区 步速 握力 跌倒 

分 类 号：R195[医药卫生—卫生统计学]