衰弱综合征对社区老年糖尿病患者跌倒影响的队列研究

Effect of frailty syndrome on falls in Chinese elderly diabetics in the communities： a prospective cohort study

目的探讨衰弱综合征与社区老年糖尿病患者跌倒之间的关系。方法在都江堰市平义社区建立／〉65岁老年人队列，分别于2014年1月和2017年1月进行问卷调查，包括自报糖尿病、跌倒、衰弱状态、认知功能和营养状况等。采用多因素logistic回归方法分析基线衰弱水平与随后3年内跌倒发生风险之间的关系。结果653名老年人接受了第一次调查，473人完成第二次调查。糖尿病的患病率为13．3％，糖尿病合并衰弱综合征老年人的跌倒发生率为62．5％。衰弱综合征是非糖尿病老年人（OR=3．87，95％CI：1．45-10．28）发生跌倒的独立危险因素，且对糖尿病老年人（OR=6．68，95％CI：1．14-38．99）的影响更强。结论衰弱综合征是老年糖尿病患者未来发生跌倒的强烈预测因子．需爱早期发现和干预。

Objective To explore the relationship between frailty syndrome and falls in the elderly diabetics, in the communities. Methods A three-year cohort study involving 653 community- dwelling adults who were over 65 years of age and participated in the Survey of Disease, Psychological and Social Needs in Dujiangyan Pingyi Community. Diabetic patients would include those who self-reported as having histories of diabetes or on anti-hyperglycemic therapies. Frailty, functional and other geriatric status were assessed respectively. Falls was defined as having had multiple falls or at least one event but with injury. Results The highest prevalence of fails was found in the group of frail diabetic group （62.5%）. Data showed that baseline frailty was associated with falls in both diabetic and non-diabetic groups but the odds ratio in the diabetic group was higher than that of the non-diabetic group （0R=3.87, 95% CI： 1.45-10.28 vs. 0R=6.68, 95% CI： 1.14-38.99）. Conclusion Frailty could be used as a strong clinical predictor to prevent falls, for the elderly diabetic Chinese living in the communities.