Prevalence of falls and their influencing factors and impaired balance among the elderly in Guangdong Province
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摘要:
目的 调查广东省社区老年人跌倒和平衡能力受损现状及跌倒影响因素。 方法 采用多阶段分层整群随机抽样的方法进行抽样调查，共有5 503名≥60岁老年人纳入分析。采用χ2检验分析老年人跌倒发生率和平衡能力受损率在不同特征老年人之间的差异，采用多因素Logistic回归分析模型分析跌倒的影响因素。 结果 本研究中老年人过去1年的跌倒发生率为11.90%，平衡能力受损率为58.37%。跌倒和平衡能力受损情况在女性、农村、文盲、无配偶和独居的老年人中较为常见(均有P＜0.05)。多因素分析显示，女性跌倒的危险性较男性高，跌倒发生情况随年龄的增加而愈发严重。农村老年人跌倒危险性高于城市老年人。老年人在家走动或做家务时最常发生跌倒(35.11%)，因跌倒造成擦伤/挫伤、骨折、扭伤/拉伤、脑震荡/脑挫裂伤和其他受伤类型的比例分别为55.77%、22.22%、17.09%、1.07%和3.85%。 结论 广东省社区老年人在过去1年内发生跌倒的情况较多，平衡能力受损现状严重，应加强对老年人的防跌倒健康宣教和以家庭防护为主的综合干预措施。 Abstract:Objective To investigate the status and influencing factors of falls and impaired balance among the community elderly in Guangdong Province. Methods A multi-stage stratified cluster random sampling method was used to carry out a sample survey. The χ2 test was used to analyze the prevalence of falls and the rate of impaired balance among the elderly with different characteristics, and a multivariate Logistic regression model was used to analyze the influencing factors of falls. Results In this study, the falls prevalence rate was 11.90% during the past year and the rate of impaired balance ability was 58.37%. Falls and impaired balance were more common among females, rural, illiterate, unmarried, and elderly people living alone (all P < 0.05). Multivariate analysis showed that the risk of falls was higher in women than in men, and the occurrence of falls became more and more serious with the increase of age. The risk of falls in rural elderly was higher than that in urban elderly. The elderly were most likely to fall when walking around the house or doing housework (35.11%). The rates of bruises/contusions, fractures, sprains/strains, concussions/brain contusions and other types of injuries caused by falls were 55.77%, 22.22%, 17.09%, 1.07%, and 3.85%, respectively. Conclusions The prevalence of falls during the past year has been high among the elderly in Guangdong Province, and their balance ability is seriously impaired. Health education for the elderly against falls and comprehensive intervention measures based on family protection should be strengthened. -
Key words:
- Elderly people /
- Falls /
- Balance ability
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表 1 广东省社区老年人过去1年跌倒发生情况[n(%)]
Table 1. The prevalence of falls among the community-dwelling elderly in Guangdong Province during the past year [n(%)]
变量 跌倒 χ2值 P值 变量 跌倒 χ2值 P值 是 否 是 否 性别 51.20 < 0.001 婚姻状况 28.68 < 0.001 男性 207(8.42) 2 250(91.58) 有配偶 465(10.70) 3 882(89.30) 女性 448(14.71) 2 598(85.29) 无配偶 190(16.44) 966(83.56) 年龄组(岁) 41.26 < 0.001 居住形式 16.82 < 0.001 60~ < 65 142(9.07) 1 424(90.93) 非独居 574(11.37) 4 476(88.63) 65~ < 70 166(10.54) 1 409(89.46) 独居 81(17.88) 372(82.12) 70~ < 75 153(13.13) 1 012(86.87) BMI (kg/m2) 6.97 0.073 75~ < 80 90(14.17) 545(85.83) 体重过低 62(13.51) 397(86.49) ≥80 104(18.51) 458(81.49) 体重正常 343(11.78) 2 569(88.22) 城乡 4.57 0.033 超重 172(10.76) 1 427(89.24) 城市 92(9.84) 843(90.16) 肥胖 78(14.63) 455(85.37) 农村 563(12.32) 4 005(87.68) 文化程度 18.04 < 0.001 文盲 244(14.73) 1 413(85.27) 小学 266(10.63) 2 236(89.37) 初中及以上 145(10.79) 1 199(89.21) 
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表 2 广东省社区老年人跌倒发生的多因素分析
Table 2. Multifactorial analysis of falls among the community-dwelling elderly in Guangdong Province
变量 跌倒 β值 sx值 Wald值 OR(95% CI)值 P值 性别 男性 1.00 女性 0.64 0.10 42.42 1.90(1.57~2.30) < 0.001 年龄组(岁) 60~ < 65 1.00 65~ < 70 0.20 0.12 2.60 1.22(0.96~1.55) 0.107 70~ < 75 0.45 0.13 12.45 1.57(1.22~2.02) < 0.001 75~ < 80 0.50 0.15 10.93 1.65(1.23~2.22) < 0.001 ≥80 0.75 0.16 22.48 2.11(1.55~2.88) < 0.001 城乡 城市 1.00 农村 0.30 0.12 5.99 1.35(1.06~1.71) 0.014 文化程度 文盲 1.00 小学 -0.10 0.10 0.89 0.91(0.74~1.11) 0.344 初中及以上 0.15 0.13 1.37 1.16(0.90~1.50) 0.242 婚姻状况 有配偶 1.00 无配偶 0.11 0.11 0.91 1.12(0.89~1.40) 0.340 居住形式 非独居 1.00 独居 0.22 0.15 2.13 1.25(0.93~1.68) 0.145 BMI(kg/m2) 体重过低 0.07 0.15 0.24 1.07(0.80~1.45) 0.627 体重正常 1.00 超重 -0.12 0.10 1.32 0.89(0.73~1.09) 0.251 肥胖 0.17 0.14 1.44 1.18(0.90~1.55) 0.230
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表 3 广东省社区老年人平衡能力受损情况
Table 3. Impaired balance ability of community-dwelling elderly in Guangdong Province
变量 CRT测试异常 TUG测试异常 TGT测试异常 平衡能力受损 例数(%) χ2值 例数(%) χ2值 例数(%) χ2值 例数(%) χ2值 性别 22.30 a 63.16 a 28.42 a 29.72 a 男性 1 076(44.03) 397(16.17) 508(21.04) 1 335(54.33) 女性 1 517(50.45) 759(24.96) 808(27.33) 1 877(61.62) 年龄组(岁) 281.83 a 626.23 a 302.65 a 399.16 a 60~ < 65 587(37.60) 127(8.11) 201(12.89) 695(44.38) 65~ < 70 637(40.60) 223(14.16) 329(21.09) 825(52.38) 70~ < 75 584(50.92) 282(24.27) 338(29.73) 742(63.69) 75~ < 80 376(59.97) 219(34.49) 217(35.69) 464(73.07) ≥80 409(74.77) 305(54.66) 231(45.65) 486(86.48) 城乡 113.10 a 84.73 a 1.26 89.25 a 城市 292(31.64) 92(9.85) 209(23.04) 416(44.49) 农村 2 301(50.82) 1 064(23.32) 1 107(24.80) 2 796(61.21) 文化程度 197.01 a 267.20 a 112.40 a 231.26 a 文盲 986(60.31) 545(32.97) 509(32.24) 1 178(71.09) 小学 1 142(46.10) 494(19.77) 603(24.55) 1 448(57.87) 初中及以上 465(34.73) 117(8.71) 204(15.28) 586(43.60) 婚姻状况 55.54 a 153.20 a 68.48 a 87.40 a 有配偶 1 941(44.98) 762(17.53) 942(22.05) 2 398(55.16) 无配偶 652(57.39) 394(34.26) 374(34.09) 814(70.42) 居住形式 39.23 a 100.52 a 22.08 a 45.23 a 非独居 2 317(46.30) 978(19.39) 1 171(23.69) 2 880(57.03) 独居 276(61.74) 178(39.47) 145(33.88) 332(73.29) BMI (kg/m2) 22.77 a 7.99 a 52.44 a 20.39 a 体重过低 263(57.42) 115(25.22) 103(23.52) 293(63.83) 体重正常 1 353(46.85) 587(20.16) 613(21.49) 1 656(56.87) 超重 717(45.29) 330(20.65) 416(26.63) 914(57.16) 肥胖 260(49.81) 124(23.35) 184(35.59) 349(65.48) 合计 2 593(47.57) 1 156(21.03) 1 316(24.51) 3 212(58.37) 注：a P＜0.05。
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