老年人居家跌倒风险自评量表在社区老年人中的比较应用研究

关键词：跌倒  风险评估  量表  老年人  社区

Keywords:fall  risk assessment  scale  older adult  community

摘要：

      摘要 目的：比较老年人居家跌倒风险自评量表（fall risk self-assessment scale， FRSAS）与修订版跌倒效能量表（modified falls efficacy scale， MFES）在社区老年人的跌倒风险评估方面的应用价值。 方法：通过便利抽样在北京市4家社区卫生服务中心招募年龄在65周岁及以上的调查对象共1710例。采用一般资料调查表、FRSAS量表和MFES量表进行资料收集，半年后通过电话随访获取跌倒发生情况。 结果：1686例完成了有效作答，1670例接受了电话随访，报告发生跌倒152例。MFES总得分为（127.77±24.39）分，满分的占比55.3%，Cronbach α系数为0.975；FRSAS总得分为（9.62±5.01）分，Cronbach α系数为0.80。两量表相关系数r为﹣0.563，呈中度负相关。MFES和FRSAS的曲线下面积（area under the curve， AUC）分别为0.615和0.739，诊断准确性FRSAS优于MFES。MFES临界值为134分时，约登指数、灵敏度、特异度、阳性预测值、阴性预测值分别为0.195、49.3%、70.2%、14.2%、93.3%；FRSAS临界值为10分时，约登指数、灵敏度、特异度、阳性预测值、阴性预测值分别为0.399、80.9%、59.0%、16.5%、96.9%。对不发生跌倒个体的预测准确率FRSAS优于MFES。 结论：与MFES相比，FRSAS没有天花板效应并且更具预测价值，可用于社区老年人跌倒风险筛查。

Abstract:

      Abstract Objective： To compare the value of the fall risk self-assessment scale（FRSAS） and the modified falls efficacy scale（MFES）in the fall risk assessment of community-dwelling older adults. Method： A total of 1710 respondents aged 65 and above were recruited from four community health service centers in Beijing through convenient sampling. The general information questionnaire， FRSAS scale and MFES scale were used for data collection， and the fall incidence was obtained through telephone follow-up six months later. Result： Total 1686 subjects completed survey， 1670 subjects received telephone follow-up， 152 subjects reported falls. The total score of MFES was （127.77±24.39）， with the full score accounting for 55.3%. Cronbach's α coefficient of MFES was 0.975. The total score of FRSAS was （9.62±5.01）， Cronbach's α coefficient was 0.80. The correlation coefficient r of the two scales was -0.563， showing a moderate negative correlation. The AUC under the curve of MFES and FRSAS were 0.615 and 0.739， respectively. The diagnostic accuracy of FRSAS was better than MFES. When the cut off value of MFES was 134， Youdon index， sensitivity， specificity， positive predictive value， negative predictive value were 0.195， 49.3%，70.2%，14.2%，93.3%， respectively. When the cut off value of FRSAS was 10， Youdon index， sensitivity， specificity， positive predictive value， negative predictive value were 0.399， 80.9%，59.0%，16.5%，96.9%， respectively. The prediction accuracy of FRSAS was better than that of MFES for individuals without falls. Conclusion： Compared with MFES， FRSAS has no ceiling effect and has more predictive value. It can be used as a fall risk screening tool for the elderly in the community.