Recurrent and Injurious Falls in the Year Following Hip Fracture: A Prospective Study of Incidence and Risk Factors From the Sarcopenia and Hip Fracture Study

被引:132
作者
Lloyd, Bradley D. [1 ]
Williamson, Dominique A. [1 ]
Singh, Nalin A. [2 ]
Hansen, Ross D. [3 ,4 ]
Diamond, Terrence H. [5 ]
Finnegan, Terence P. [6 ]
Allen, Barry J. [7 ]
Grady, Jodie N. [1 ]
Stavrinos, Theodora M. [1 ,2 ]
Smith, Emma U. R. [1 ]
Diwan, Ashish D. [8 ]
Fiatarone Singh, Maria A. [1 ,9 ,10 ]
机构
[1] Univ Sydney, Exercise Hlth & Performance Fac Res Grp, Fac Hlth Sci, Lidcombe, NSW 2141, Australia
[2] Royal Prince Alfred Hosp, Camperdown, NSW 2050, Australia
[3] Royal N Shore Hosp, Gastrointestinal Invest Unit, St Leonards, NSW 2065, Australia
[4] Royal N Shore Hosp, Ctr Vivo Body Composit, St Leonards, NSW 2065, Australia
[5] St George Hosp, Kogarah, NSW, Australia
[6] Royal N Shore Hosp, Dept Aged Care & Rehabil Med, St Leonards, NSW 2065, Australia
[7] St George Hosp, Ctr Expt Radiat Oncol, Canc Care Ctr, Kogarah, NSW, Australia
[8] Univ New S Wales, Fac Med, Sydney, NSW, Australia
[9] Hebrew SeniorLife, Boston, MA USA
[10] Tufts Univ, Jean Mayer USDA Human Nutr Res Ctr Aging, Boston, MA 02111 USA
来源
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES | 2009年 / 64卷 / 05期
基金
英国医学研究理事会;
关键词
Falls; Hip fracture; Osteoporosis; Aging; COMMUNITY-DWELLING WOMEN; VITAMIN-D; OLDER-PEOPLE; CALCIUM SUPPLEMENTATION; NUTRITIONAL ASSESSMENT; PHYSICAL-ACTIVITY; ELDERLY PERSONS; HEALTH OUTCOMES; SELF-EFFICACY; INDEX;
D O I
10.1093/gerona/glp003
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
The incidence and etiology of falls in patients following hip fracture remains poorly understood. We prospectively investigated the incidence of, and risk factors for, recurrent and injurious falls in community-dwelling persons admitted for surgical repair of minimal-trauma hip fracture. Fall surveillance methods included phone calls, medical records, and fall calendars. Potential predictors of falls included health status, quality of life, nutritional status, body composition, muscle strength, range of motion, gait velocity, balance, walking endurance, disability, cognition, depression, fear of falling, self-efficacy, social support, physical activity level, and vision. 193 participants enrolled in the study (81 +/- 8 years, 72% women, gait velocity 0.3 +/- 0.2 m/s). We identified 227 falls in the year after hip fracture for the 178 participants with fall surveillance data. Fifty-six percent of participants fell at least once, 28% had recurrent falls, 30% were injured, 12% sustained a new fracture, and 5% sustained a new hip fracture. Age-adjusted risk factors for recurrent and injurious falls included lower strength, balance, range of motion, physical activity level, quality of life, depth perception, vitamin D, and nutritional status, and greater polypharmacy, comorbidity, and disability. Multivariate analyses identified older age, congestive heart failure, poorer quality of life, and nutritional status as independent risk factors for recurrent and injurious falls. Recurrent and injurious falls are common after hip fracture and are associated with multiple risk factors, many of which are treatable. Interventions should therefore be tailored to alleviating or reversing any nutritional, physiological, and psychosocial risk factors of individual patients.
引用
收藏
页码:599 / 609
页数:11
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