Do Elderly People at More Severe Activity of Daily Living Limitation Stages Fall More?

作者：Henry Sanchez John T; Kurichi Jibby E; Xie Dawei; Pan Qiang; Stineman Margaret G^*

来源：American Journal of Physical Medicine and Rehabilitation, 2012, 91(7): 601-610.

DOI：10.1097/PHM.0b013e31825596af

• Accidental Falls
• Aged
• Risk Assessment
• Activities of Daily Living

Objective: The aim of this study was to explore how activity of daily living (ADL) stages and the perception of unmet needs for home accessibility features associate with a history of falling.
Design: Participants were from a nationally representative sample from the Second Longitudinal Survey of Aging conducted in 1994. The sample included 9250 community-dwelling persons 70 yrs or older. The associations of ADL stage and perception of unmet needs for home accessibility features with a history of falling within the past year (none, once, or multiple times) were explored after accounting for sociodemographic characteristics and comorbidities using a multinomial logistic regression model.
Results: The adjusted relative risk of falling more than once peaked at 4.30 (95% confidence interval, 3.29-5.61) for persons with severe limitation (ADL-III) compared those with no limitation (ADL-O) then declined for those at complete limitation (ADL-IV). The adjusted relative risks of falling once and multiple times were 1.42 (95% confidence interval, 1.07-1.87) and 1.85 (95% confidence interval, 1.44-2.36), respectively, for those lacking home accessibility features.
Conclusions: Risk of falling appeared greatest for those whose homes lacked accessibility features and peaked at intermediate ADL limitation stages, presumably at a point when people have significant disabilities but sufficient function to remain partially active.

• 出版日期2012-7