転倒恐怖者の移動能力と生活状況に関する研究

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The objective of this study is to clarify conditions of daily living and physical function of elderly women who have a fear of falling. From May 2002 to July 2002, we studied elderly women aged 65 or above living in Kitamimaki-Village in Nagano Prefecture. Of the 824 targeted population, 274 were studied, which accounted for 33.4%. The 10-m walking time, the maximal step length and the 40-cm step test were studied to measure the Good Walker's Index and the tandem gait test was used to detect balance capability. A questionnaire administered through an interview elicited information on the number of falls during the past year, presence of fear of falling, degree of satisfaction in daily life, physical activity, reason for living, and fall-related self-efficacy. Here the fear of falling is defined as anxiety and fear sufficient to suppress activity in order to avoid a fall, even when the subject is capable of maintaining a normal lifestyle. Based on this definition, the study sample was divided into two groups: a group having fear of falling (F group) and the other not having such fears (N group). Furthermore, we carried out discriminant analysis using fear of falling as an independent variable and 8 explanatory variables owning no multicollinearity. The average age of the F group (77.2±6.6 yrs.) was significantly higher than that of the N group (74.3±6.3 yrs., p<0.001). Moving ability and balance capability of the F group were significantly lower than that of the N group in all survey items (p<0.001). The frequency of falling during the past year was significantly higher in the F group (2.1±10.4 times) than in the N group (1.3±8.9 times). The F group also showed a significant lowness in both daily physical activity and satisfaction in daily life. The 19 survey items for fall-related showed a significant difference in the two groups. Discriminant analysis resulted in a 75.2% apparent error rate and eigenvalues of 0.200 (p<0.001). The order of discriminant function coefficient was 1) sitting and standing, 2) airing sleeping mattress, and 3) taking a bath. These actions are characterized by large burdens on lower extremity muscles, the necessity to balance on one leg, the carrying of heavy objects and the vertical movement of the center of gravity. Any of these actions may cause a loss in balance. As a result of the investigation of capabilities related to motion and balance, we extracted the following factors related to fear of falling: age, walking, standing up and sitting down, taking a bath and carrying heavy objects. In overall our study suggested that safely participating in such daily activities would contribute to the recovery and maintainance of confidence that a fall would not occur, and it would lead to appropriate repeated exercise considered as training to prevent a fall.

転倒恐怖者の移動能力と生活状況に関する研究

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