老年痴呆患者跌倒危险因素的临床分析

Clinical analysis of risk factors for falls in patients with dementia

目的探讨老年痴呆患者跌倒的危险因素。方法选取北京老年医院118例（73．1±6．1）岁临床诊断痴呆患者，将入选病例按跌倒和未跌倒分为两组，即跌倒组、未跌倒组，给予患者行简易智能状态量表（MMSE）、临床痴呆量表（CDR）、日常生活能力量表（ADL）、神经精神科问卷（NPI）及统一帕金森病量表（UPDRS）运动评分并对数值进行对照研究。以logistic回归模型分析各种危险因素如体位性低血压、服用抗精神药物、服用镇静催眠药物、运动障碍及精神行为异常和跌倒之间的关系。结果NPI和UPDRS在跌倒组及未跌倒组中差异有统计学意义（t值分别为2．237和2．213，P均〈0．05），单因素及多因素回归分析显示精神行为异常、运动障碍和跌倒有密切相关性（β=0．77和0．86，P均〈0．05）。结论在老年痴呆患者中运动障碍、精神行为异常和跌倒密切相关，为减少患者骨折及其他并发症，针对以上情况给予干预措施是十分必要的。

Objective To explore the risk factors for falls in patients with dementia. Methods Totally 118 patients diagnosed with dementia were divided into fails group and no falls group. The scores of mini mental state examination （MMSE）, clinical dementia rating （CDR） , activity of daily living scale （ADL）, neuropsychiatric inventory （NPI） and unified Parkinson＇s disease rating scale （UPDRS） were compared between the two groups. The relationship between falls and their risk factors were analyzed by logistic regression model. Results The NPI and UPDRS scores were higher in falls group than in no falls group（t=2. 237,2. 213; both P〈0.05）. Multivariate analysis showed that dyskinesia and behavior disorders were significantly associated with an increased risk of falls （β=0.77 and 0.86, both P〈0.05）. Conclusions Dyskinesia and behavior disorders may be related to falls in patients with dementia and intervention measures of these risk factors are very essential.