上海市老年人群跌倒的影响因素研究  

Study on the influencing factors of falls among the elderly in Shanghai

作　　者：王常颖[1] 张蕴伟 丁汉升[1] WANG Chang-ying;ZHANG Yun-wei;DING Han-sheng(Shanghai Health and Health Development Research Center(Shanghai Institute of Medical Science and Technology Information),Shanghai 200031,China)

机构地区：[1]上海市卫生和健康发展研究中心(上海市医学科学技术情报研究所),上海200031

出　　处：《现代预防医学》2024年第11期2049-2054,2065,共7页Modern Preventive Medicine

基　　金：国家自然科学基金(72074152)。

摘　　要：目的探索老年人群跌倒的影响因素,为预防跌倒提供证据。方法研究基于上海市179141人大样本数据,最终纳入40244人。首先选取基本情况、居住环境、健康状况和生活习惯为自变量,跌倒情况为因变量,分别开展单因素和多因素logistic回归分析;其次选取负性情绪为自变量,跌倒情况为因变量,开展多因素logistic回归分析。结果老年人90 d内跌倒发生率为19.55%。独居(30 d内跌倒OR=1.161,95%CI:1.051~1.282;31~90 d跌倒OR=1.173,95%CI:1.070~1.287)、居住环境不干净不整洁(30 d内跌倒OR=1.775,95%CI:1.331~2.367;31~90 d跌倒OR=1.117,95%CI:1.037~1.203)、患慢性病数量≥3种(30 d内跌倒OR=2.024,95%CI:1.763~2.322;31~90 d跌倒OR=2.089,95%CI:1.835~2.379)、使用尿便垫(30 d内跌倒OR=1.581,95%CI:1.351~1.850;31~90 d跌倒OR=1.445,95%CI:1.239~1.685)以及外出活动频次低(有时外出30 d内跌倒OR=1.458,95%CI:1.171~1.816;31~90 d跌倒OR=1.359,95%CI:1.114~1.658;几乎不外出30 d内跌倒OR=2.084,95%CI:1.673~2.596;几乎不外出31~90 d跌倒OR=2.053,95%CI:1.682~2.506)是30 d内、31~90 d跌倒的危险因素。年龄越大(70~79岁OR=1.179,95%CI:1.063~1.308;80岁及以上OR=1.159,95%CI:1.040~1.292)、视力不正常(OR=1.235,95%CI:1.079~1.414)、家务活需要他人帮助完成(部分由他人完成OR=1.572,95%CI:1.139~2.169;完全由他人完成OR=1.649,95%CI:1.269~2.143)是30 d内跌倒的危险因素。自变量之间无共线性。与未感到负性情绪者相比,经常感到疲乏的老人(30 d内跌倒OR=0.886,95%CI:0.811~0.968;31~90 d跌倒OR=0.900,95%CI:0.828~0.977)跌倒风险更低,经常感到生气的老人(30 d内跌倒OR=1.491,95%CI:1.248~1.782;31~90 d跌倒OR=1.270,95%CI:1.067~1.513)跌倒风险更高。结论老人与他人共同居住,保持室内环境干净整洁、地面平整无杂物,以及保持良好的情绪状态,能够降低跌倒风险。对于ADL和认知功能相对较好的老年人,应当鼓励其适当外出,开展强度及频度适中的身体活动,有利于预Objective To explore the influencing factors of falls in the elderly and to provide evidence for the prevention of falls.Methods The study was based on a large sample of 179141 individuals in Shanghai,with a final inclusion of 40244 participants.Firstly,independent variables including basic demographics,living environment,health status,and lifestyle habits were selected,with falls as the dependent variable,and univariate and multivariate logistic regression analyses were conducted.Secondly,negative emotions were considered as independent variables,and multivariate logistic regression analysis was performed.Results The fall incidence rate in the elderly within 90 days was 19.55%.Living alone(fall within 30 days:OR=1.161,95%CI:1.051-1.282;fall between 31-90 days:OR=1.173,95%CI:1.070-1.287),unclean living environment(OR=1.775,95%CI:1.331-2.367;OR=1.117,95%CI:1.037-1.203),having≥3 chronic diseases(OR=2.024,95%CI:1.763-2.322;OR=2.089,95%CI:1.835-2.379),using urine or stool pads(OR=1.581,95%CI:1.351-1.850;OR=1.445,95%CI:1.239-1.685),and low frequency of outdoor activities(occasional outdoor activitie:OR=1.458,95%CI:1.171-1.816;OR=1.359,95%CI:1.114-1.658;rarely going out:OR=2.084,95%CI:1.673-2.596;OR=2.053,95%CI:1.682-2.506)were identified as risk factors for falls within 30 days and 31 to 90 days.Advanced age(70-79 years:OR=1.179,95%CI:1.063-1.308;80 years and above:OR=1.159,95%CI:1.040-1.292),abnormal vision(OR=1.235,95%CI:1.079-1.414),and needing assistance with household chores(partially completed by others:OR=1.572,95%CI:1.139-2.169;fully completed by others:OR=1.649,95%CI:1.269-2.143)were risk factors for falls within 30 days.There was no collinearity between the independent variables.Compared with those who did not feel negative emotions,the elderly who frequently felt fatigued had a lower risk of falling(fall within 30 days:OR=0.886,95%CI:0.811-0.968;fall between 31-90 days:OR=0.900,95%CI:0.828-0.977),while the elderly who frequently felt angry had a higher risk of falling(fall within 30 days:OR=1.491,95%CI:1.

关 键 词：老年 跌倒 负性情绪 影响因素 

分 类 号：C913.6[经济管理]