高齢者の転倒と身体的・精神的要因との関連

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Falls are common in elderly people but they remain a serious public health problem because they can cause hip fractures, thus resulting in patients becoming bedridden. Numerous epidemiological studies have reported various kinds of the risk factors related to falls; such as aging, ADL impairment, immobility, a decline in strength, balance, walking speed, history of falls, cognitive impairment, medication use, and female preponderance. In this review, we summarized the risk factors for falls in the elderly people living in the community, especially regarding the relationship between falls and physical disabilities and/or depression, because physical disabilities and depression are important problems in the elderly people. In cross-sectional studies, fallers (those who reported falls within 1 year before the survey) have been reported to have the following physical characteristics; muscle weakness, gait and balance deficits, and depression. According to prospective cohort studies, physical disabilities (muscle weakness, gait and balance deficits) are strong risk factors for falls. However, few studies have so far examined the threshold which makes it easy to fall regarding muscle strength, balance, and walking speed. Depression has also been reported to be associated with falls, but its analysis requires a separate survey because some studies have reported such an association to disappear after adjusting for several confounding factors. Several studies reported the interaction and probable synergism between risk factors, namely, the risk of falling dramatically increased as the number of risk factors increased. In addition, another study reviewed the association between late-life depression and anxiety, and physical disability, thus suggesting that both factors increased the risk for each other. From these results, a combination of physical disability and depression is thus suggested to increase the risk of falls. Further research is necessary to ascertain the interaction of physical and mental factors regarding falls in order to develop a screening (selection) method to select subjects who are indicated to undergo preventive exercise intervention.
2004-03-25

高齢者の転倒と身体的・精神的要因との関連

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