PDF(Pubmed)
Abstract：
BACKGROUND: Falls in older adults significantly impact overall health and healthcare costs. Intrinsic capacity (IC) reflects functional reserve and is an indicator of healthy aging.
OBJECTIVE: To explore the association between IC and recent falls (≤ 90 days) in community-dwelling octogenarians from the Aging and Longevity in the Sirente geographic area (IlSIRENTE) study.
METHODS: The Minimum Data Set for Home Care (MDS-HC) and supplementary questionnaires and tests were used to assess the five IC domains: locomotion, cognition, vitality, psychology, and sensory. Scores in each domain were rescaled using the percent of maximum possible score method and averaged to obtain an overall IC score (range 0-100).
RESULTS: The study included 319 participants (mean age 85.5 ± 4.8 years, 67.1% women). Mean IC score was 80.5 ± 14.2. The optimal IC score cut-off for predicting the two-year risk of incident loss of at least one activity of daily living (ADL) was determined and validated in a subset of 240 individuals without ADL disability at baseline (mean age 84.7 ± 4.4 years, 67.1% women). Participants were then stratified into low (< 77.6) and high (≥ 77.6) IC categories. Those with high IC (63.9%) were younger, more often males, and had lower prevalence of recent falls, disability, multimorbidity, and polypharmacy. Logistic regression models including IC as a continuous variable revealed a significant association between higher IC and lower odds of falls. This association was significant in the unadjusted (odds ratio [OR] 0.96, 95% confidence interval [CI] 0.94-0.98, p < 0.001), age- and sex-adjusted (OR 0.96, 95% CI 0.94-0.98, p < 0.001), and fully adjusted models (OR 0.96, 95% CI 0.93-0.99, p = 0.003). When considering IC as a categorical variable, unadjusted logistic regression showed a strong association between high IC and lower odds of falls (OR 0.31, 95% CI 0.16-0.60, p < 0.001). This association remained significant in both the age- and sex-adjusted (OR 0.30, 95% CI 0.15-0.59, p < 0.001) and fully adjusted models (OR 0.33, 95% CI 0.16-0.82, p = 0.007). The locomotion domain was independently associated with falls in the unadjusted (OR 0.98, 95% CI 0.97-0.99, p < 0.001), age- and sex-adjusted (OR 0.97, 95% CI 0.96-0.99, p < 0.001), and fully adjusted model (OR 0.98, 95% CI 0.96-0.99, p < 0.001).
CONCLUSIONS: This is the first study using an MDS-HC-derived instrument to assess IC. Individuals with higher IC were less likely to report recent falls, with locomotion being an independently associated domain.
CONCLUSIONS: Lower IC is linked to increased odds of falls. Interventions to maintain and improve IC, especially the locomotion domain, may reduce fall risk in community-dwelling octogenarians.
OBJECTIVE: To explore the association between IC and recent falls (≤ 90 days) in community-dwelling octogenarians from the Aging and Longevity in the Sirente geographic area (IlSIRENTE) study.
METHODS: The Minimum Data Set for Home Care (MDS-HC) and supplementary questionnaires and tests were used to assess the five IC domains: locomotion, cognition, vitality, psychology, and sensory. Scores in each domain were rescaled using the percent of maximum possible score method and averaged to obtain an overall IC score (range 0-100).
RESULTS: The study included 319 participants (mean age 85.5 ± 4.8 years, 67.1% women). Mean IC score was 80.5 ± 14.2. The optimal IC score cut-off for predicting the two-year risk of incident loss of at least one activity of daily living (ADL) was determined and validated in a subset of 240 individuals without ADL disability at baseline (mean age 84.7 ± 4.4 years, 67.1% women). Participants were then stratified into low (< 77.6) and high (≥ 77.6) IC categories. Those with high IC (63.9%) were younger, more often males, and had lower prevalence of recent falls, disability, multimorbidity, and polypharmacy. Logistic regression models including IC as a continuous variable revealed a significant association between higher IC and lower odds of falls. This association was significant in the unadjusted (odds ratio [OR] 0.96, 95% confidence interval [CI] 0.94-0.98, p < 0.001), age- and sex-adjusted (OR 0.96, 95% CI 0.94-0.98, p < 0.001), and fully adjusted models (OR 0.96, 95% CI 0.93-0.99, p = 0.003). When considering IC as a categorical variable, unadjusted logistic regression showed a strong association between high IC and lower odds of falls (OR 0.31, 95% CI 0.16-0.60, p < 0.001). This association remained significant in both the age- and sex-adjusted (OR 0.30, 95% CI 0.15-0.59, p < 0.001) and fully adjusted models (OR 0.33, 95% CI 0.16-0.82, p = 0.007). The locomotion domain was independently associated with falls in the unadjusted (OR 0.98, 95% CI 0.97-0.99, p < 0.001), age- and sex-adjusted (OR 0.97, 95% CI 0.96-0.99, p < 0.001), and fully adjusted model (OR 0.98, 95% CI 0.96-0.99, p < 0.001).
CONCLUSIONS: This is the first study using an MDS-HC-derived instrument to assess IC. Individuals with higher IC were less likely to report recent falls, with locomotion being an independently associated domain.
CONCLUSIONS: Lower IC is linked to increased odds of falls. Interventions to maintain and improve IC, especially the locomotion domain, may reduce fall risk in community-dwelling octogenarians.
摘要：
背景：老年人跌倒会显著影响整体健康和医疗保健成本。内在能力（IC）反映了功能储备，是健康衰老的指标。
目的：从Sirente地理区域（IlSIRENTE）的衰老和长寿研究中探索社区居住的八十岁老人的IC与近期跌倒（≤90天）之间的关系。
方法：使用家庭护理最低数据集（MDS-HC）和补充问卷和测试来评估五个IC领域：运动，认知，活力,心理学,和感官。使用最大可能得分的百分比方法重新缩放每个域中的得分,并取平均值以获得总体IC得分(范围0-100)。
结果：该研究包括319名参与者（平均年龄85.5±4.8岁，67.1％的妇女）。平均IC评分为80.5±14.2。在基线时没有ADL残疾的240名个体的子集（平均年龄84.7±4.4岁，67.1％的妇女）。然后将参与者分为低（<77.6）和高（≥77.6）IC类别。IC高(63.9%)的人更年轻,更常见的是男性，最近跌倒的患病率较低，残疾,多浊度,和多药房。包括IC作为连续变量的Logistic回归模型显示，较高的IC和较低的跌倒几率之间存在显着关联。这种关联在未调整的(比值比[OR]0.96，95%置信区间[CI]0.94-0.98，p<0.001)中显著，年龄和性别调整(OR0.96，95%CI0.94-0.98，p<0.001)，和完全调整的模型(OR0.96，95%CI0.93-0.99，p=0.003)。当将IC视为分类变量时，非校正逻辑回归显示,高IC与较低跌倒几率之间存在强关联(OR0.31,95%CI0.16-0.60,p<0.001).在年龄和性别调整模型（OR0.30，95％CI0.15-0.59，p<0.001）和完全调整模型（OR0.33，95％CI0.16-0.82，p=0.007）中，这种相关性仍然显着。运动域与未调整的下降独立相关（OR0.98，95％CI0.97-0.99，p<0.001），年龄和性别调整(OR0.97，95%CI0.96-0.99，p<0.001)，和完全调整模型(OR0.98，95%CI0.96-0.99，p<0.001)。
结论：这是第一项使用MDS-HC衍生仪器评估IC的研究。IC较高的个人不太可能报告最近的下跌，运动是一个独立关联的领域。
结论：较低的IC与跌倒几率增加有关。维护和改善IC的干预措施，尤其是运动领域，可以降低社区居住的八十岁老人的跌倒风险。
目的：从Sirente地理区域（IlSIRENTE）的衰老和长寿研究中探索社区居住的八十岁老人的IC与近期跌倒（≤90天）之间的关系。
方法：使用家庭护理最低数据集（MDS-HC）和补充问卷和测试来评估五个IC领域：运动，认知，活力,心理学,和感官。使用最大可能得分的百分比方法重新缩放每个域中的得分,并取平均值以获得总体IC得分(范围0-100)。
结果：该研究包括319名参与者（平均年龄85.5±4.8岁，67.1％的妇女）。平均IC评分为80.5±14.2。在基线时没有ADL残疾的240名个体的子集（平均年龄84.7±4.4岁，67.1％的妇女）。然后将参与者分为低（<77.6）和高（≥77.6）IC类别。IC高(63.9%)的人更年轻,更常见的是男性，最近跌倒的患病率较低，残疾,多浊度,和多药房。包括IC作为连续变量的Logistic回归模型显示，较高的IC和较低的跌倒几率之间存在显着关联。这种关联在未调整的(比值比[OR]0.96，95%置信区间[CI]0.94-0.98，p<0.001)中显著，年龄和性别调整(OR0.96，95%CI0.94-0.98，p<0.001)，和完全调整的模型(OR0.96，95%CI0.93-0.99，p=0.003)。当将IC视为分类变量时，非校正逻辑回归显示,高IC与较低跌倒几率之间存在强关联(OR0.31,95%CI0.16-0.60,p<0.001).在年龄和性别调整模型（OR0.30，95％CI0.15-0.59，p<0.001）和完全调整模型（OR0.33，95％CI0.16-0.82，p=0.007）中，这种相关性仍然显着。运动域与未调整的下降独立相关（OR0.98，95％CI0.97-0.99，p<0.001），年龄和性别调整(OR0.97，95%CI0.96-0.99，p<0.001)，和完全调整模型(OR0.98，95%CI0.96-0.99，p<0.001)。
结论：这是第一项使用MDS-HC衍生仪器评估IC的研究。IC较高的个人不太可能报告最近的下跌，运动是一个独立关联的领域。
结论：较低的IC与跌倒几率增加有关。维护和改善IC的干预措施，尤其是运动领域，可以降低社区居住的八十岁老人的跌倒风险。
