河北省社区老年人跌倒流行现状及影响因素分析

Analysis on falls prevalence and influencing factors among the elderly in Hebei Province

目的了解河北省社区60岁及以上老年人跌倒流行现状及影响因素,为预防老年人跌倒提供参考。方法于2022年6月至2023年3月采用多阶段分层随机抽样的方法,抽取河北省4个区(县)的2294名60岁及以上社区老年人进行问卷调查,内容包括老年人的一般人口学信息、行为习惯、疾病史、用药情况、日常生活活动能力(ADL)等,同时收集跌倒发生情况,包括跌倒类型、时间、地点、原因等。采用SPSS 22.0软件进行χ2检验和多因素logistic回归分析。结果河北省社区老年人过去1年的跌倒发生率为14.04%,标化率为13.91%。老年人最容易在夏天跌倒(36.84%),跌倒发生地点多数在家中(52.08%),且以上午居多(49.86%)。影响跌倒的外部因素中,男性排名前3位的是:地面不平(29.79%)、地面湿滑(29.08%)和没有扶手或支撑(26.95%),女性排名前3位的是:地面不平(31.36%)、没有扶手或支撑(26.36%)和地面有障碍物(25.45%)。多因素logistic回归分析结果显示,女性(OR=1.337,95%CI:1.046~1.709)、使用助行器(OR=2.070,95%CI:1.398~3.066)、患糖尿病(OR=1.665,95%CI:1.245~2.228)、患关节炎(OR=1.774,95%CI:1.320~2.385)、服用精神类药物(OR=1.646,95%CI:1.020~2.658)、自评健康状况一般(OR=1.364,95%CI:1.042~1.786)和自评健康状况差(OR=1.959,95%CI:1.298~2.955)与老年人跌倒发生高风险相关。结论河北省老年人跌倒发生率较高,应以女性、使用助行器、患糖尿病和关节炎、服用精神类药物、自评健康状况一般和差的老年人为重点人群,采取有针对性的措施进行干预。

Objective To understand the prevalence and influencing factors of falls in elderly(≥60 years old)in Hebei Province,and provide the reference for preventing falls among the elderly.Methods From June 2022 to March 2023,a multi-stage stratified cluster random sampling method was used to select 2294 residents(≥60 years old)from 4 districts(counties)in Hebei Province as the subjects.The investigation was conducted with the questionnaire,including the general demographic information,behavior habits,disease history,drug use and activities of daily living(ADL)of the elderly.At the same time,the occurrence of falls was collected,including fall type,time,place,reason,etc.Theχ2 test and multivariate logistic regression were used to analyze the data.The used software was SPSS 22.0.Results The incidence of falls was 14.04%in the past year,the normalization rate was 13.91%in community elderly in Hebei Province.The elderly were most likely to fall in summer(36.84%),most fell at home(52.08%),and most fell in the morning(49.86%).Among external-influencing factors,the ground uneven(29.79%),the ground slippery(29.08%)and no handrails or support(26.95%)were for males;the ground uneven(31.36%),no handrails or support(26.36%)and obstacles on the ground(25.45%)were for females.The results of multivariate logistic regression showed that female(OR=1.337,95%CI:1.046-1.709),usage of walker(OR=2.070,95%CI:1.398-3.066),diabetes(OR=1.665,95%CI:1.245-2.228),arthritis(OR=1.774,95%CI:1.320-2.385),taking psychoactive drugs(OR=1.646,95%CI:1.020-2.658),self-rated health status as normal(OR=1.364,95%CI:1.042-1.786)and self-rated health status as poor(OR=1.959,95%CI:1.298-2.955)were related to high risk of falls in elderly.Conclusion The incidence of falls among the elderly in Hebei Province is higher.The elderly with female,walker,diabetes,arthritis,taking psychoactive drugs,self-rated health status as normal and self-rated health status as poor should be the important subjects.Targeted interventions measures should be taken for the important subjects.