摘要目的 了解浙江省城乡社区60岁以上老年人害怕跌倒而减少活动的发生现状及其影响因素.方法 2013年10-12月由经过培训的调查员入户对l 972名60岁以上老年人进行问卷调查,采用单因素和多因素logistic回归分析其影响因素.结果 因害怕跌倒而减少活动的老年人比例为43.15％(95％CI:40.97％～ 45.34％),其中男性和女性分别为41.79％(95％CI:38.61％～44.98％)和44.36％(95％CI:41.34％～ 47.38％),不同性别的差异无统计学意义(x2=1.32,P＞0.05);60～、70～及≥80岁组因害怕跌倒而减少活动的比例分别为37.07％、44.87％和59.04％(趋势x2=48.93,P＜0.01).过去12个月发生过跌倒老年人中,因害怕跌倒而减少活动的比例为51.94％,未曾发生过跌倒老年人中的比例为41.52％,差异有统计学意义(x2=11.56,P＜0.01).多因素logistic 回归分析显示,自评健康状况一般(OR=1.53)或不好(OR=1.69)、视力不良(相距1～5m视物无困难:OR=1.95,＜1m才能辨认:OR=2.98)、听力不良(需大声交谈:OR=1.77)、经常使用辅具(OR=2.71)、年龄≥80岁(OR=1.56)、被诊断骨质疏松(OR=3.35)、被诊断眩晕症(OR=3.05)是老年人因害怕跌倒而减少活动的可疑危险因素,而文化程度高(大学及以上:OR=0.54,中学/中专:OR=0.54,小学:OR=0.74)是保护因素.结论 浙江省城乡社区60岁以上老年人中害怕跌倒而减少活动的比例高.应针对患骨质疏松和眩晕症、视力和听力困难及自评健康状况差、经常使用辅具、文化程度低、高龄老年人开展健康教育,鼓励其适当运动,减少跌倒发生.

abstractsObjective To investigate the epidemiologic characteristics and factors associated with the avoidance of activity,that induced by fear of falling in the community-dwelling elderly so as to provide evidence for preventing elderly from falling and to increase the quality of life.Methods A cross-sectional study was conducted in 1 972 elderly in Zhejiang.Data were collected through face-to-face interview.Both Univariate and multivariate logistic regression models were used to explore the related factors on the avoidance of activity induced by fear of falling.Results Of the 1 972 elderly,43.15％ (95％CI:40.97％-45.34％) appeared avoidance of activity induced by fear of falling.There were no significant difference between males (41.79％,95％CI:38.61％-44.98％) and females (44.36％,95％CI:41.34％-47.38％),with x2=1.32,P＞0.05.The corresponding figures of the 60-69 years group,70-79 years group and the ≥80 years group were 37.07％,44.87％ and 59.04％,respectively (Trend x2=48.93,P＜0.01).Of those elderly who ever fell in the past 12 months,51.94％ (95％CI:46.34％-57.53％) of them were afraid of falling which would lead to avoid of engaging in physical activities.Of the elderly who had no histories of falling in the past 12 months,41.52％ (95％CI:39.14％-43.89％) feared of falling and avoided engaging in related activities (x2=11.56,P＜0.01).Results from the Multivariate logistic regression analysis showed that the related factors would include general/poor perceived health status (OR=1.53-1.69),impaired vision (OR =1.95-2.98),impaired hearing (OR =1.77),use of assistive devices (OR =2.71),osteoporosis (OR=3.35),dizziness (OR=3.05),age ≥80 years old (OR=1.56) and the level of received education.Conclusion Avoidance of physical activity induced by fear of falling among community-dwelling elderly was commonly seen.Health education and intervention measures should be strengthened to the elderly,so as to encourage them to engaging in physical activities and to improve their quality of life.