背景:跌倒恐惧(FOF)已成为一个重要的公共卫生问题,导致中老年人过度残疾。FOF与死亡率之间的关系尚不清楚。
方法:著名的电子数据库(PubMed,WebofScience,Cochrane图书馆,Embase,CINHAL,PsycINFO,Scopus,中国国家知识基础设施,中国生物医药光盘,和万方数据库)从开始到2023年10月21日(数据更新于2024年6月9日),用于调查FOF与死亡率之间关系的队列或纵向研究。使用I2定量评估研究之间的异质性。固定效应模型计算了合并效应大小。
结果:共有7项队列研究,包括27,714名参与者,在这篇系统综述和荟萃分析中进行了分析。荟萃分析结果表明FOF与死亡率呈正相关,FOF患者的死亡风险显着增加(风险比[HR]:1.29,95%置信区间[CI]:1.19-1.41,p<0.05)。亚组分析表明,年龄,男性,抑郁症的临床诊断,慢性疾病的数量,由于FOF的活动限制,FOF水平与死亡率相关。
结论:FOF与死亡率呈正相关,这需要进一步的大样本前瞻性研究和长期随访来证实,为临床医生干预FOF以降低中老年人死亡率提供证据.
BACKGROUND: Fear of falling (FOF) has emerged as a significant public health issue, contributing to excess disability among middle-aged and older adults. The
association between FOF and mortality remains unclear.
METHODS: Prominent electronic databases (PubMed, Web of Science, the Cochrane Library, Embase, CINHAL, PsycINFO, Scopus, China National Knowledge Infrastructure, China Biology Medicine disc, and Wanfang Database) were searched from inception until October 21, 2023 (data updated on June 9, 2024), for cohort or longitudinal studies investigating the
association between FOF and mortality. The heterogeneity between studies was quantitatively assessed using I2. A fixed-effect model calculated the pooled effect size.
RESULTS: A total of seven cohort studies, including 27,714 participants, were analyzed in this systematic
review and meta-analysis. The meta-analysis results demonstrated a positive
association between FOF and mortality, with a significant increase in the risk of mortality for those with FOF (hazard ratio [HR]:1.29, 95 % confidence interval [CI]: 1.19-1.41, p < 0.05). Subgroup analysis indicated that age, male sex, clinical diagnosis of depression, number of chronic diseases, activity restriction due to FOF, and FOF levels were associated with mortality.
CONCLUSIONS: FOF and mortality have a positive
association, which needs to be confirmed by further prospective studies with large samples and long-term follow-up to provide evidence for clinicians to intervene in FOF to reduce mortality in middle-aged and older adults.