美国CDC社区老年人跌倒风险自评表与跌倒功效量表在社区老年人跌倒风险评估中的比较研究  

The Self-rated Fall Risk Questionnaire and Modified Falls Efficacy Scale in Assessing the Fall Risk in Community-dwelling Older Chinese Adults:a Comparative Study

作　　者：宋俊敏[1] 杨鹏 刘刚[1] 赵志广[2] 万丹婷 王海瑞 徐子茜 王东海 夏俊杰[1] SONG Junmin;YANG Peng;LIU Gang;ZHAO Zhiguang;WAN Danting;WANG Hairui;XU Ziqian;WANG Donghai;XIA Junjie(Shenzhen Center for Disease Control and Prevention,Shenzhen 518055,China;Shenzhen Center for Chronic Disease Prevention and Treatment,Shenzhen 518020,China)

机构地区：[1]深圳市疾病预防控制中心,广东省深圳市518055 [2]广东省深圳市慢性病防治中心,518020

出　　处：《中国全科医学》2022年第25期3097-3100,3106,共5页Chinese General Practice

摘　　要：背景美国疾病预防控制中心(CDC)公布的老年人跌倒风险自评表(FRQ)是目前少有的应用于社区老年人跌倒风险评估的自评价量表,此量表操作简便,应用价值广。跌倒功效量表(MFES)已被广泛应用于国内外老年人跌倒风险评估领域。对两者进行评估效能的比较很有意义。目的通过与MFES对比,评估美国CDC公布的FRQ在中国社区老年人群跌倒风险评估中的适用性。方法采用便利抽样法纳入203例2017年12月至2018年2月在社区卫生服务中心体检、就诊或接种疫苗的≥65岁老年人进行问卷调查。调查问卷包括基本情况、FRQ、MFES三部分。分别以既往1年跌倒≥1次及≥2次为状态变量,通过受试者工作特征曲线(ROC)进行FRQ和MFES两个量表的灵敏度、特异度、阳性预测值、阴性预测值的比较。结果203例被调查老年人中,58例(28.6%)既往1年发生过跌倒。跌倒组FRQ得分高于非跌倒组,差异有统计学意义(P<0.05);跌倒组MFES得分与非跌倒组比较,差异无统计学意义(P>0.05)。FRQ得分≥4分的高风险组跌倒发生率高于低风险组,差异有统计学意义(P<0.05);MFES得分≤112分的高风险组跌倒发生率与低风险组比较,差异无统计学意义(P>0.05)。以既往1年跌倒≥1次为状态变量时,FRQ和MFES的ROC曲线下面积(AUC)分别为0.74〔95%CI(0.68,0.81)〕和0.59〔95%CI(0.50,0.68)〕;以既往1年跌倒≥2次为状态变量时,AUC分别增加到0.80〔95%CI(0.70,0.90)〕和0.65〔95%CI(0.52,0.78)〕。分别以4分和112分作为跌倒风险的区分标准,FRQ和MFES的灵敏度分别为81.0%和53.5%,特异度分别为51.7%和60.0%。结论与MFES相比,FRQ能够更加灵敏地筛选出跌倒高风险人群,同时具有更简便的操作和社区适用性。Background The Self-rated Fall Risk Questionnaire(FRQ)developed by the US CDC is one of the few questionnaires applied for fall risk self-assessment in community-dwelling older adults,which is thought to be simple and highly applicable.The Modified Falls Efficacy Scale(MFES)is also widely used in the fall risk assessment in older adults.Thus the comparison between the Self-rated FRQ and MFES in identifying fall risk in older adults would be meaningful.Objective To explore the applicability of the Chinese version of Self-rated FRQ(FRQ-C)in assessing the fall risks in community-dwelling older Chinese adults by comparing it with the Chinese version of MFES(MFES-C).Methods A total of 203 seniors above 65 who received physical examination services,treatment services,or vaccination services from the community health center were selected by use of convenience sampling and invited to attend a survey for understanding their demographics,and fall risk rated by the MFES-C and the Self-rated FRQ-C.ROC analysis was conducted to assess the performance(sensitivity,specificity,positive and negative predictive values) of the Self-rated FRQ-C and MFES-C in the prediction of having at least one or two falls in the past year. Results Fifty-eight(28.6%) of them fell once or more in the past year. The mean score of the Self-rated FRQ-C for the fall group was higher than that of the non-fall group with a statistically significant difference(P<0.001). But no significant difference in the mean score of the MFES-C was found between the two groups(P>0.05). Those with high fall risk assessed by the Self-rated FRQ-C(≥ 4 points) had higher prevalence of fall(P<0.05). However,no higher prevalence of fall was found in those with high fall risk assessed by the MFES-C(≤ 112 points)(P>0.05). The AUC values in identifying having one or more falls in the past year for the Self-rated FRQ-C and MFES-C were 0.74〔95%CI(0.68,0.81)〕 and 0.59 〔95%CI(0.50,0.68)〕. When identifying having two or more falls in the past year,the AUC value of the Sel

关 键 词：跌倒风险自评表 跌倒功效量表 跌倒 危险性评估 社区卫生服务 老年人 

分 类 号：R197[医药卫生—卫生事业管理] R12[医药卫生—公共卫生与预防医学]