功能性步态评价与Berg平衡量表对社区老年人跌倒风险的预测价值

Predictive Value of Functional Gait Assessment and Berg Balance Scale for Fall in Community-dwelling Older Adults

目的比较功能性步态评价（FGA）和Berg平衡量表（BBS）对75～85岁中国社区老年人跌倒的预测价值。方法随机选取北京市3个社区75～85岁老年人162人进行FGA、BBS评估，根据过去1年内是否跌倒分为跌倒组和非跌倒组。结果跌倒组和非跌倒组FGA和BBS均有菲常高度恩著性差异（P〈0．001）。FGA总分与BBS总分显著正相关（F0．723，P=0．001）。除闭眼行走（P=0．31）外，FGA总分与其他分项明显正相关（P〈0．01）；FGA受试者T作特征曲线下面积比为0．90l，BBS为0．872。根据Youden指数，FGA对跌倒的预测值为19．5（满分30分1，敏感性85．5％，特异性81．2％；BBS的预测值为48．5（满分56分），敏感性78．3％，特异性83．3％。结论FGA预测社区老年人跌倒的敏感性优于BBS，特异性与BBS相似，总体效能优于BBS。

Objective To compare the prediction of Functional Gait Assessment （FGA） and Berg balance scale （BBS） for fall among community-dwelling older adults aged 75-85 years old. Methods 162 older adults randomly selected from 3 communities in Beijing were evaluated with FGA and BBS. They were divided as fallers and nonfallers according to the history of fall during the last year. Results The scores of FGA and BBS increased significantly in the nonfallers compared with the fallers （P〈0.001）. The total scores of FGA correlated with the scores of BBS （r-0.723, P〈0.001）. The total scores of FGA significantly correlated with the scores of items of FGA （P〈0.01）, ex- cept that of walking with eyes closed （P=0,31）. According to the Receiver Operating Characteristic （ROC） Curve, the area under the curve was 0.901 for FGA, and 0.872 for BBS. According to the Youden index, the cutoff value of FGA was 19.5, with sensitivity of 85.5% and specificity of 81.2%. The cutoff value of BBS was 48.5, with sensitivity of 78.3% and specificity of 83.3%. Conclusion FGA is more effec- tive than BBS for predicting the fall in community-dwelling older adults, which is more sensitive and similarly specific.