Research On Sensitive Risk Factors And Evaluation Grade Of Falls In The Elderly

Objective:The aim of this study is to analysis the risk factors related to fall in older adults, to select sensitivity indexes that could predict fall event through the analysis of relationships between risk factors and fall event, and then establish evaluation grade to predict fall risk for elders.Method:We recruited 361 individuals aged 55-90 years in Beijing, China. We collected basic information, living habits, medical history, medication history, fall history, and sports psychological condition through the questionnaires. We tested sensory-nerve muscle function, the control ability of postural stability, and the ability of response in the laboratory. First, we use binary Logistic regression analysis to select the potential variables, fall history was defined as dependent variable in this analysis; Second, multiple Logistic regression and optimal truncation point regression analysis were used to calculate the best cut-off point ROC curves, and then establish the evaluation grade, the frequency of fall event was defined as dependent variable.Results:1 There were 33.80% people fell in the past year,27.87% fell once, 29.51% fall twice, and 42.62% fall 3 times or more than 3 times.2 There were 11 fall risk variables entered the regression equation, female (OR=2.472), osteoporosis (OR=1.938), syncope/dizziness (OR=1.734), active knee position sense angle difference (OR=1.958), Romberg 30s C90 Area eyes large area (OR=1.998), choose the long reaction time (OR=1.398), gait from the moment the hip angle is large (OR=1.050), trunk, large scope of activities (OR=1.076), and a moment of pelvic acceleration (OR=1.545) were risk factors for the occurrence of falls in older adults; while the 10% contrast visual acuity (OR=0.791) and Tandem C90 Angle (OR=0.995) is a protective factor for the occurrence of falls in older adults.3 When standardized total probability was 51.174, Youden index to predict elder fall 1 times was the largest, the sensitivity was 85.3%, specificity was 31.5%; when the standardized total probability was 54.437, Youden index to predict elder fall 2 times was the largest, the sensitivity was 61.5%, specificity was 53.1%; when standard total probability was 56.985, Youden index to predict elder fall 3 times was the largest, the sensitivity was 50%, specificity was 65.5%.Conclusion:1 This study screened sensitive indexes of the elderly fall risk occurrence prediction effect is better, and the sensitive index of the influence degree of the fall is different, its from large to small:10% visual contrast sensitivity difference>sex>osteoporosis> fainting/dizzy> pelvic acceleration instability> choice reaction time> trunk shaking amplitude of walking> walking hip extension does not fully> active knee position sense angle difference> standing body lateral sway significantly. This tip can be targeted falls prevention work for the elderly to carry out.2 whether old people with osteoporosis, ever fainting\dizzy symptoms, 10% contrast visual acuity is sensitive, selective reaction is a sensitive and walk hip extension is sufficient for the occurrence of falls in elderly people and the degree of pre critical fall.3 this study according to the old people the incidence of falls in the standardized total probability prediction was established, the elderly fall risk assessment rating:1≤Fall risk index< 3, no risk of falls; 3≤Fall risk index< 6, low risk of falls; 6≤ Fall risk index< 9, moderate risk of falling; 9≤Fall risk index≤10, height fall risk.