不同性别老年人握力与跌倒及跌倒伤害的相关性分析

Associations between Grip Strength and Falls as well as Fall Injuries among Senior Citizens

目的分析中国社区不同性别老年人握力与未来3年跌倒及跌倒伤害的关联,为跌倒筛查及干预策略提供理论依据。方法数据来源于2015年和2018年中国健康与养老追踪调查(CHARLS)两波数据中60岁及以上老年人。并采用修正的泊松回归分析不同性别老年人握力与跌倒及跌倒伤害的关联,控制变量包括:年龄、性别、居住地、婚姻、受教育水平、自评健康状况、慢性病史、用药数量、吸烟、饮酒、抑郁及BMI。结果根据纳入排除标准筛选后共纳入7088名老年人,平均年龄(68.04±6.54)岁,其中男性占比48.65%(3448/7088)。在2015—2018年三年期间,分别有23.24%(1647/7088)和10.06%(713/7088)男女性老年人发生跌倒及跌倒伤害。调整人口学特征、健康状况及生活方式后,握力值每升高1kg,跌倒及跌倒伤害发生风险分别降低1.9%(RR=0.981,95%CI:0.973,0.989)和1.7%(RR=0.983,95%CI:0.972,0.995)。性别分层后发现,男性握力每增加1kg,跌倒发生风险降低2.2%(RR=0.978,95%CI:0.967,0.989),而跌倒伤害未发现显著关联。女性握力每增加1kg,跌倒和跌倒伤害发生风险分别降低1.6%(RR=0.984,95%CI:0.972,0.996)和1.8%(RR=0.982,95%CI:0.967,0.998)。结论老年人的握力值越高,未来3年跌倒的风险越低;且与老年男性相比,女性握力值越高,未来3年跌倒伤害事件发生风险越低。在社区及临床使用中,可考虑将握力作为老年人跌倒风险评估的工具。

To analyze associations between grip strength and falls as well as fall injuries among Chinese community-based senior citizens,and to provide a theoretical basis for fall screening and intervention strategies.Methods Data were obtained from citizens aged 60 years and above in two periods from the China Health and Retirement Longitudinal Study(CHARLS):2015 and 2018.Adjusted Poisson regression was used to analyze associations between grip strength and falls and fall injuries among of the citizens of different genders.The control variables included:age,gender,place of residence,marriage,education level,self-assessed health,number of chronic diseases,number of medications,smoking,alcohol consumption,depression,and BMI.Results A total of 7088 senior citizens were enrolled according to the inclusion and exclusion criteria,with a mean age of(68.04±6.54)years old,from which 48.65%(3448/7088)were male.During the three-year period 2015-2018,23.24%(1647/7088)and 10.06%(713/7088)of the two genders experienced falls and fall injuries,respectively.After adjusting for demographic characteristics,health status,and lifestyle,for every lkg increase in grip strength value,the risk of falls and fall injuries decreased by 1.9%(RR=0.981,95%CI:0.973,0.989)and 1.7%(RR=0.983,95%CI:0.972,0.995),respectively.After stratification by gender,a 2.2%reduction in the risk of fall occurrence was found for each lkg increase in grip strength in males(RR-0.978,95%Cl:0.967,0.989),whereas no significant association was found for fall injuries.For women,the risk of falling and fall injury decreased by 1.6%(RR-0.984,95%CI:0.972,0.996)and 1.8%(RR=0.982,95%Cl:0.967,0.998),respectively.Conclusions Higher grip strength in senior citizens of both genders was associated with a lower risk of fall over the year study.I In females,higher grip strength was also correlated with a reduced risk of fall-related injuries.Grip strength may be considered as a tool for fall risk assessment in senior citizens and for clinical use.