老化社區之老年女性跌倒及相關危險因子之流病調查

Epidemiological Survey of Falls and Associated Risk Factors in Old Females in an Aging Community

張軒睿(Hsuan-Jui Chang) ； 張尹凡(Yin-Fan Chang) ； 楊宜青(Yi-Ching Yang) ； 陳全裕(Chuan-Yu Chen) ； 張秦松(Chin-Sung Chang) ； 杜嘉煒(Chia-Wei Tu) ； 趙育箴(Yu-Jang Chao) ； 謝裕弘(Yu-Hung Hsieh) ； 吳至行(Chih-Hsing Wu)

《台灣老年醫學暨老年學雜誌》 5卷1期 (2010/02) Pp. 50-61

https://doi.org/10.29461/TGG.201002.0005

摘要

目的：跌倒在台灣是老人事故傷害的第二大原因。過去對偏遠地區做的相關研究較少，本研究探討台灣偏遠老化地區老年婦女跌倒盛行率及危險因子。
方法：高雄縣田寮鄉65歲以上老年人口已超過23%。本研究於2009年7月，針對田寮鄉全鄉65歲以上婦女共1,040位，進行隨機抽樣（效力=0.9）。經由廣播或逐戶拜訪通知，使參加者至各村最近的檢查點，並由經專門訓練之固定人員進行結構式問卷調查，共完成有效樣本368份，完成率為75.9%。
結果：在368位受訪婦女當中，其中在過去一年曾跌倒者有83人(22.6%)，共計100次跌倒。在跌倒地點統計方面，有28%在室內跌倒，其中以客廳和浴室為主；有72%在室外跌倒，以道路、農地、山區為主。在單變項分析中，與過去一年曾經跌倒者有顯著相關的危險因子為自評健康狀況、身體質量指數等。在邏輯斯複迴歸分析中，與過去一年曾經跌倒者呈負相關因子為自評健康狀況、身體質量指數、糖尿病，與過去一年曾經跌倒者呈正相關因子為使用葡萄糖胺習慣。
結論：本研究顯示，偏遠地區老年婦女跌倒盛行率偏高，地點則以室外為主，尤其以自評健康狀況較差、身體質量指數較低、有使用葡萄糖胺及非糖尿病者，是跌倒的獨立性危險相關因子。

關鍵字

跌倒 ； 葡萄糖胺 ； 身體質量指數 ； 糖尿病 ； 偏遠地區

並列摘要

Objectives: In Taiwan, fall is the second leading accident-related death in the elderly; however, related studies in aging communities in remote areas remain limited. The purpose of this study is accordingly to evaluate the prevalence of fall and associated risk factors in the female elderly residents in a remote aging community in Taiwan.
Methods: Residents aged 65 and over account for more than 23% of the total population in Tianliao Township, Kaohsiung County. Subjects of the study were recruited from the 1, 040 aged women in Tianliao Township, using the simple random sampling method (power=0.9). Participants were called to the nearest examination stop via broadcasting or door-to-door invitation in each village. A standardized face-to-face interview based on structurized questionnaires was conducted by well-trained interviewers in July 2009. Finally, a total of 368 valid questionnaires were collected, leading to a response rate of 75.9%.
Results: Of the 368 female elderly, 83 (22.6%) subjects had experienced a total of 100 times of fall in the preceding year. Most (72%) of the fall events took place outdoors, including streets sidewalks, farmland, and mountain area. Those who experienced fall indoors (28%) suffered the episode mainly in the living room and bathroom. Univariate analyses showed that the significant associated factors were self-perceived health status and body mass index. Multiple logistic regression analysis revealed that self-perceived health status, body mass index, and diabetes mellitus were inversely related to fall, but using glucosamine was positively related to fall episode.
Conclusion: This study finds that the prevalence of fall in female elderly living in a remote aging community is consistently high. Falls tend to occur outdoors more often than indoors. Worse self-perceived health status, lower body mass index, use of glucosamine and non-diabetic subjects are independent risk factors for fall.

並列關鍵字

fall ； glucosamine ； body mass index ； diabetes ； rural community