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王玉波,陈雪丽,Qing Shen,Daniel KY Chan,Huong Van Nguyen.住院期间反复跌倒的老年患者认知损伤特点的临床回顾性研究[J].中国康复医学杂志,2010,25(8):740~743
住院期间反复跌倒的老年患者认知损伤特点的临床回顾性研究    点此下载全文
王玉波  陈雪丽  Qing Shen  Daniel KY Chan  Huong Van Nguyen
北京老年医院康复科,北京海淀区温泉路118号,100095
基金项目:
DOI:
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摘要:
      摘要 目的:探索导致老年患者住院期间反复跌倒的相关因素,焦点在其认知损伤的特点,目的是探索可借鉴的管理经验。 方法:回顾性地研究了在澳大利亚新南威尔士州Bankstown-Lidcombe医院老年科住院治疗期间发生跌倒的患者,其中住院期间跌倒1次以上的70例、1次的269例,并随机抽取没发生过跌倒的70例为对照组。同时,分析了部分患者的简易智能检查量表(MMSE)总分和各亚项目分数。 结果:住院老年患者反复跌倒的独立危险因素是痴呆、脑卒中、房颤和住院时间>5周,保护性因素有英语背景。反复跌倒的患者的MMSE分值明显低于单次跌倒和未发生跌倒的患者(分别为17.3±6.7, 20.2±6.2, 24.0±5.1,P<0.01),反复跌倒患者在“瞬间记忆”、“注意力和计算力”和“视空间结构”方面分值明显低于单次跌倒患者。 结论:认知功能障碍是住院老年患者反复跌倒的主要原因,尤其是在瞬间记忆、延时记忆和视空间结构方面。老年人住院期间跌倒应规范管理,预防为主,尤其是认知功能损伤的患者。
关键词:住院患者  老年人  反复跌倒  认知障碍
Characteristics associated with recurrent falls among the elderly within aged care wards in a tertiary hospital in Australia: the effect of cognitive impairment    Download Fulltext
Department of Rehabilitation, Beijing Geriatric Hospital, Beijing, 100095
Fund Project:
Abstract:
      Abstract Objective:To determine the factors associated with recurrent falls in aged inpatients at a tertiary hospital in Australia, with a focus on the cognitive domains of recurrent fallers and to explore the management experience for reference. Method:A retrospective study was proceeded on the characteristics of 70 aged inpatients who sustained≥1 falls, 269 patients who sustained once fall; and 70 non-fallers during their hospital admission. The available mini-mental state examination (MMSE) scores were analyzed. Result: The independent risk factors for recurrent falls were the history of dementia, stroke, or atrial fibrillation, and the lengths of patients staying in hospital were >5 weeks. The protective factor for falls were the patients′ ability of speaking English. Recurrent fallers had significantly lower MMSE scores compared with once fallers and non-fallers (17.3±6.7, 20.2±6.2, 24.0±5.1 respectively, P<0.01); and the proportion of recurrent fallers who had MMSE < 18 was larger than that in the other two groups (54.1%, 34.4% and 10.8% respectively, P<0.01). In addition, patients with recurrent falls were more likely to have significantly lower scores in the ′registration′, ′attention and calculation′, ′recall′ and ′praxis′ domains of MMSE than the once fallers. Conclusion: Cognitive impairment particularly in short-term memory, recall and visuospatial perception domains, may contribute to recurrent falls in the inpatient population.
Keywords:inpatient  the elderly  recurrent fall  cognitive impairment
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