Abstract：
OBJECTIVE: Activity and participation are important for older adults as they are associated with well-being and quality of life. Falls, emergency department (ED) visits, and hospitalizations are adverse health outcomes that impact older adults. Limited research has investigated whether measurement of activity and participation are related to adverse health events in community dwelling older adults. This study sought to examine the association between activity and participation with falls, ED visits, and hospitalization over 1 year in community dwelling older adults.
METHODS: A secondary analysis of a longitudinal clinical trial of 341 community dwelling older adults was conducted. The sample mean age was 80.9 (SD = 7.7) years and 83% were female. One-year risk of falls was associated with baseline Late Life Function and Disability Instrument (LLFDI) components of overall function and disability (frequency and limitations dimensions). Incident rate ratios (IRRs) and 95% CIs were calculated.
RESULTS: For each 5-point higher score (clinically meaningful difference) in activity as measured by LLFDI-overall function (adjusted for age, race, sex, comorbidities and fall history), there was an 18% lower rate of falls (IRR = 0.82, 95% CI = 0.74-0.92); 12% reduction in hospitalizations (IRR = 0.88; 95% CI = 0.77-0.99); and 11% lower rate of emergency room visits (IRR = 0.89, 95% CI = 0.81-0.98). Greater participation as measured by the LLFDI limitations dimension was related to fewer falls (IRR = 0.93, 95% CI = 0.87-1.00) and hospitalizations (IRR = 0.91, 95% CI = 0.83-0.99).
CONCLUSIONS: Greater activity and participation are associated with a lower incidence of falls, ED visits, and hospitalizations representing an important consideration for targeted physical therapist interventions.
UNASSIGNED: Physical therapists are uniquely positioned to identify and address reduced activity and participation. If activity and participation are specifically targeted and improved through physical therapy, undesirable distal health outcomes might be prevented or minimized.
Greater activity and participation were found to be related to lower rate of falls, ED visits, and hospitalizations in a sample of 341 older adults who lived in the community.
METHODS: A secondary analysis of a longitudinal clinical trial of 341 community dwelling older adults was conducted. The sample mean age was 80.9 (SD = 7.7) years and 83% were female. One-year risk of falls was associated with baseline Late Life Function and Disability Instrument (LLFDI) components of overall function and disability (frequency and limitations dimensions). Incident rate ratios (IRRs) and 95% CIs were calculated.
RESULTS: For each 5-point higher score (clinically meaningful difference) in activity as measured by LLFDI-overall function (adjusted for age, race, sex, comorbidities and fall history), there was an 18% lower rate of falls (IRR = 0.82, 95% CI = 0.74-0.92); 12% reduction in hospitalizations (IRR = 0.88; 95% CI = 0.77-0.99); and 11% lower rate of emergency room visits (IRR = 0.89, 95% CI = 0.81-0.98). Greater participation as measured by the LLFDI limitations dimension was related to fewer falls (IRR = 0.93, 95% CI = 0.87-1.00) and hospitalizations (IRR = 0.91, 95% CI = 0.83-0.99).
CONCLUSIONS: Greater activity and participation are associated with a lower incidence of falls, ED visits, and hospitalizations representing an important consideration for targeted physical therapist interventions.
UNASSIGNED: Physical therapists are uniquely positioned to identify and address reduced activity and participation. If activity and participation are specifically targeted and improved through physical therapy, undesirable distal health outcomes might be prevented or minimized.
Greater activity and participation were found to be related to lower rate of falls, ED visits, and hospitalizations in a sample of 341 older adults who lived in the community.
摘要：
目的：活动和参与对老年人很重要，因为它们与健康和生活质量有关。瀑布,急诊科（ED）访问，和住院是影响老年人的不良健康结果.有限的研究调查了活动和参与的测量是否与社区居住老年人的不良健康事件有关。这项研究试图检查活动和参与与跌倒之间的关系，ED访问，在社区居住的老年人中住院超过1年。
方法：对341名社区居住老年人的纵向临床试验进行了二次分析。样本平均年龄为80.9(SD=7.7)岁，83%为女性。一年的跌倒风险与基线晚年功能和残疾指标（LLFDI）的总体功能和残疾（频率和限制维度）相关。计算事件发生率比(IRRs)和95%CI。
结果：对于通过LLFDI-总体功能（根据年龄调整，种族,性别,合并症和秋季历史)，跌倒率降低18%(IRR=0.82,95%CI=0.74-0.92);住院率降低12%(IRR=0.88;95%CI=0.77-0.99);急诊室就诊率降低11%(IRR=0.89,95%CI=0.81-0.98).通过LLFDI限制维度衡量的更多参与与更少的跌倒（IRR=0.93，95％CI=0.87-1.00）和住院（IRR=0.91，95％CI=0.83-0.99）相关。
结论：更多的活动和参与与较低的跌倒发生率相关，ED访问，和住院是有针对性的物理治疗师干预的重要考虑因素。
■物理治疗师在识别和解决减少的活动和参与方面具有独特的定位。如果活动和参与是有针对性的，并通过物理治疗得到改善，不良的远端健康结果可能会被预防或最小化。
发现更多的活动和参与与较低的跌倒率有关，ED访问，和居住在社区的341名老年人的住院情况。
方法：对341名社区居住老年人的纵向临床试验进行了二次分析。样本平均年龄为80.9(SD=7.7)岁，83%为女性。一年的跌倒风险与基线晚年功能和残疾指标（LLFDI）的总体功能和残疾（频率和限制维度）相关。计算事件发生率比(IRRs)和95%CI。
结果：对于通过LLFDI-总体功能（根据年龄调整，种族,性别,合并症和秋季历史)，跌倒率降低18%(IRR=0.82,95%CI=0.74-0.92);住院率降低12%(IRR=0.88;95%CI=0.77-0.99);急诊室就诊率降低11%(IRR=0.89,95%CI=0.81-0.98).通过LLFDI限制维度衡量的更多参与与更少的跌倒（IRR=0.93，95％CI=0.87-1.00）和住院（IRR=0.91，95％CI=0.83-0.99）相关。
结论：更多的活动和参与与较低的跌倒发生率相关，ED访问，和住院是有针对性的物理治疗师干预的重要考虑因素。
■物理治疗师在识别和解决减少的活动和参与方面具有独特的定位。如果活动和参与是有针对性的，并通过物理治疗得到改善，不良的远端健康结果可能会被预防或最小化。
发现更多的活动和参与与较低的跌倒率有关，ED访问，和居住在社区的341名老年人的住院情况。
