2023 年第 11 期 第 18 卷

中国城乡社区中老年人群跌倒状况调查及相关因素分析

Survey of fall condition and analysis of related factors among middle-aged and elderly people in urban and rural communities in China

作者：周婷1刘韬滔2孙超3施红4

英文作者：Zhou Ting1 Liu Taotao2 Sun Chao3 Shi Hong4

单位：1北京医院胸外科国家老年医学中心中国医学科学院老年医学研究院，北京100730；2北京医院重症医学科国家老年医学中心中国医学科学院老年医学研究院，北京100730；3北京医院护理部国家老年医学中心中国医学科学院老年医学研究院，北京100730；4北京医院老年医学科国家老年医学中心中国医学科学院老年医学研究院，北京100730

英文单位：1Department of Thoracic Surgery Beijing Hospital National Center of Gerontology Institute of Geriatric Medicine Chinese Academy of Medical Sciences Beijing 100730 China; 2Department of Intensive Care Unit Beijing Hospital National Center of Gerontology Institute of Geriatric Medicine Chinese Academy of Medical Sciences Beijing 100730 China; 3Department of Nursing Beijing Hospital National Center of Gerontology Institute of Geriatric Medicine Chinese Academy of Medical Sciences Beijing 100730 China; 4Department of Geriatrics Beijing Hospital National Center of Gerontology Institute of Geriatric Medicine Chinese Academy of Medical Sciences Beijing 100730 China

关键词：跌倒；中老年；相关因素；中国健康与养老追踪调查

英文关键词：Fall;Middleagedandelderly;Relatedfactors;ChinaHealthandRetirementLongitudinalStudy

• 摘要：

• 目的  调查中国城乡社区中老年人群发生跌倒的状况，并分析跌倒的危险因素。方法  基于中国健康与养老追踪调查2018年的数据，纳入18 105名≥45岁人群，根据2015年以来3年是否发生跌倒分为跌倒组（3 482名）和非跌倒组（14 623名）。采集2组患者的人口学资料和健康与生理状态、合并症诊断与治疗、生活行为等相关变量资料，采用单因素和多因素Logistic回归方法分析跌倒的相关因素。结果  抽样调查来自28个省（自治区、直辖市），跌倒发生率中位数19.2%（95%置信区间：18.2%～20.9%）。45～54岁人群跌倒发生率15.7%（95%置信区间：14.7%～16.7%)，其中缺少家庭照护人群跌倒发生率23.7%（95%置信区间：18.5%～28.8%）；≥75岁人群跌倒发生率26.7%（95%置信区间：24.8%～28.5%）。受访人群年龄（62±10）岁，跌倒组年龄及男性比例高于非跌倒组（均P<0.001）。多因素Logistic回归分析结果发现年龄（比值比=1.019）、家庭照护评分（比值比=0.893）、教育程度评分（比值比=0.940）、残障疼痛评分（比值比=1.598）、共病合计评分（比值比=1.148）、日常运动强度评分（比值比=1.204）和下肢运动能力评分（比值比=0.850）均为发生跌倒的重要影响因素（均P<0.05）。对应的危险因素项包括高龄、健康与生理状态差、基础疾病较多、高强度运动增加，保护因素包括加强家庭照护、教育程度高、下肢运动能力强。结论  全国城乡社区中老年人群跌倒发生率较高。跌倒危险因素包括高龄、基础疾病较多、高强度运动增加等，而加强家庭照护是保护因素。

• Objective  To investigate fall condition among middle-aged and elderly people in urban and rural communities in China and to analyze their risk factors. Methods  Based on data from the China Health and Retirement Longitudinal Study in 2018, 18 105 cases of people ≥45 years old were included. They were divided into the fall group(n=3 482) and the non fall group(n=14 623) according to whether fall occurred in the past three years from 2015. Demography data, health and physiological status, diagnosis and treatment of comorbidities, life behavior and other related variable data of the two groups of patients were collected. Univariate and multivariate Logistic regression analysis was used to evaluate the related factors for fall. Results  The sampling survey was conducted in 28 provinces(autonomous regions, municipalities), with a median fall rate of 19.2%［95% confidence interval(CI): 18.2%-20.9%］. The incidence of fall among people aged 45 to 54 years old was 15.7%（95%CI: 14.7%-16.7%）, including 23.7%(95%CI: 18.5%-28.8%) of those lacking of family care. The incidence of fall among people over 75 years old was 26.7%(95%CI: 24.8%-28.5%). The age of the surveyed population was (62±10) years old, and the age and male proportion of the fall group were higher than those of the non fall group(both P<0.001). Multivariate Logistic regression analysis showed that age［odds ratio(OR)=1.019］, home care score(OR=0.893), education score(OR=0.940), disability pain score(OR=1.598), total comorbidity score(OR=1.148), exercise intensity score(OR=1.204) and lower limb exercise ability score(OR=0.850) were important related factors for fall(all P<0.05). The corresponding risk factors included advanced age, poor health and physiological status, more basic diseases, and an increase in high-intensity exercise; protective factors included strengthening family care, high education level, and strong lower limb motor ability. Conclusions    The incidence of fall among middle-aged and elderly people in urban and rural communities is relatively high in the country. Risk factors for fall include advanced age, more basic diseases and an increase in high-intensity exercise, among which strengthening family care is protective factor.