老年跌倒研究概况与进展

张玉陈蔚(华山医院老年科,上海200040)12;12R1611712A121005-9202(2008)09-0929-03:(1963-),,,,,;(ICD-10),:¹;º112,651/31,,8050%,5%~15%;10%~15%,,1/4612~42,706,200,75,018612~42,65,21%~23%,43%~44%;20002500,50,160~18012~42,65,,,111111111,,,,,,,,,,,,,,11112,/,,,,1111311250%,,,,,,113,;,,,,Alzheimer:;,,,114,;,;,1152211,152212,162,Danish,,,,;,172#929#9213,,,4~6,600,22%,20%162331118~12231111(thedynamicgaitindex,DGI)ShumwayCook,;8;0~3,4,0~24,;1831112(functionalreachtest,FRT)Duncan,;(90b)7;5min30%~36%31113(mult-idirectionalreachtest,MDRT)()Berg,31114Berg(bergbalancescale,BBS),15~20min14;5(0~4),0,4,56,,;BBS45BBS31115(one-legbalancetest)5s,,,36%,76%,31%31116(balancesel-fperceptionstest,BSPT);120~60,31117(modifiedgaitabnormalityratingscale,GARS-M);7,4(0~3),0~21,,,62%87%31118Tinetti(tinettigaitandbalancetest);9,16,7,12,(+)2810~15min19~24,;19,,70%53%312112,13231211(physicalperformancetest,PPT);95(0~4),36,,71%79%,Tinetti31212(timeupandgotest,TU>)Podsiadlo,1~2min,20s,;30s,;20~29s,87%,,BBS313114~16231311(thefallsefficacyscale,FES)Tinetti,10,1~10,100FES,,31312(surveyofactivitiesandfearoffallingintheelderly,SAFFE);SAFFE11,,;FES31313(modifiedfallsefficacyscale,MFES)FES,14,4;;11,0()~10()31314(activties-specificbalanceconf-idencescale,ABC)Powell,;,,16;0()~100()FES,ABC,,31315(SPPB)10,(DEF)Morse,314116,172Barthel(MBI)London#930#2008528(LHS):;(MMSE):41182411,,(),;,412,,,,,;,,413(homefallhazardsassessments,HFHA),,,,,;,;414,,1000mgD800IU,D,,415,,416,,560,10,,,,61OliverD,BrittonM,MartinFC,etal1Developmentandevaluationofev-idence-basedriskassessmenttool(stratify)topredictwhichelderlyinpa-tientswillfal:lcase-controlandcohortstudies1J21BrMedJ,1997;315(7115):1049-5312FullerGF1Fallsintheelderly1J21AmFamPhys,2000;61(7):2159-6613HendrieD,HallSE,ArenaG,etal1HealthsystemcostsoffallsofolderaldutsinWesternAustralia1J21AustHealthRev,2004;28(3):363-7314RungeM1Diagnosisoftheriskofaccidentalfallsintheelderly1J21TherUmsch,2002;59:351-815KannusP,ParkkariJ,NiemiS,etal1Preventionofhipfractureinelderlypeoplewithuseofahipprotector1J21NEnglJMed,2000;343(21):1506-1316KallinK,JensenJ,OlssonLL,etal1Whytheeldlyfallinresidentialcarefacilitiesandsuggestedremedies1J21JFamPract,2004;53:41-5217KemptonA,VanBeurdenE,SladdenT,etal1Olderpeoplecanstayontheirfeet:finalresultsofacommunity-basedfallspreventionprogram1J21HealthPromotInt,2000;15(1):27-3318McConveyJ,BennettSE1Reliabilityofthedynamicgaitindexinindivid-ualswithmultiplesclerosis1J21ArchPhysMedRehabi,l2005;86(1):130-319NewtonRA1Validityofthemult-idirectionalreachtest:apracticalmeas-ureforlimitsofstabilityinolderadults1J21JGerontolABiolSciMedSc,i2001;56(4):248-52110VellasBJ,WayneSJ,RomeroL,etal1One-legbalanceisanimportantpredictorofinjuriousfallsinolderpersons1J21JAmGeriatrSoc,1997;45(6):735-8111ShumwayCA,GruberW,BaldwinM,etal1Theeffectofmultidimention-alexercisesonbalance,mobility,andfallriskincommunity-dwellingo-lderadults1J21PhysTher,1997;77(1):46-7112VanswearingenJM,PahchalKA,BonioP,etal1Assessingrecurrentfallriskofcommunitydwelling,frailolderveteransusingspecifictestsofmobilityandthephysicalperformancetestoffunction1J21JGerontolABioSciMedSc,i1998;53(6):457-64113MichelR,RejeanH,FrancoisP,etal1ScreeningolderadultsatriskoffallingwiththeTinettibalancescale1J21Lancet,2000;356(16):1001-2114HillK,SchwarzJ,KalogeropoulosA,etal1Fearoffallinginelderlyper-sons:Associationwithfalls,functionalability,andqualityoflife1J21JGeronto:lPsycholSciSocSc,i2003;58(5):283-90115LachmanME,HowlandJ,TennstedeS,etal1Fearoffallingandactivityrestriction:thesurveyofactivitiesandfearoffallingintheelderly(SAFE)1J21JGerontolBPsycholSciSocSc,i1998;53(1):43-50116JamesK,RichardsonMD1Factorsassociatedwithfallsinelderpatientswithdiffusepolyneuropathy1J21JAmGeriatrSoc,2002;50(11):1767-73117EggerJ,GrossmannG,AuchterlonieIA1Benignsleepmyoclonusinin-fancymistakenforepilepsy1J21BMJ,2003;326(10):975-6118LinJT,LaneJM1Fallsintheelderlypopulation1J21PhysMedRehabilClinNAm,2005;16:109-28112007-07-132007-12-052(袁左鸣)#931#9