Brooke N Klatt, Subashan Perera, Pamela M Dunlap, Andrea L Rosso, Jennifer S Brach
{"title":"活动和参与与社区老年人未来的跌倒、住院和急诊就诊有关。","authors":"Brooke N Klatt, Subashan Perera, Pamela M Dunlap, Andrea L Rosso, Jennifer S Brach","doi":"10.1093/ptj/pzae087","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Activity and participation are important for older adults as they are associated with well-being and quality of life. Falls, emergency department (ED) visits, and hospitalizations are adverse health outcomes that impact older adults. Limited research has investigated whether measurement of activity and participation are related to adverse health events in community dwelling older adults. This study sought to examine the association between activity and participation with falls, ED visits, and hospitalization over 1 year in community dwelling older adults.</p><p><strong>Methods: </strong>A secondary analysis of a longitudinal clinical trial of 341 community dwelling older adults was conducted. The sample mean age was 80.9 (SD = 7.7) years and 83% were female. One-year risk of falls was associated with baseline Late Life Function and Disability Instrument (LLFDI) components of overall function and disability (frequency and limitations dimensions). Incident rate ratios (IRRs) and 95% CIs were calculated.</p><p><strong>Results: </strong>For each five-point higher score (clinically meaningful difference) in activity as measured by LLFDI-overall function (adjusted for age, race, sex, comorbidities and fall history), there was an 18% lower rate of falls (IRR = 0.82, 95% CI = 0.74-0.92), 12% reduction in hospitalizations (IRR = 0.88; 95% CI = 0.77-0.99), and 11% lower rate of emergency room visits (IRR = 0.89, 95% CI = 0.81-0.98). Greater participation as measured by the LLFDI limitations dimension was related to fewer falls (IRR = 0.93, 95% CI = 0.87-1.00) and hospitalizations (IRR = 0.91, 95% CI = 0.83-0.99).</p><p><strong>Conclusion: </strong>Greater activity and participation are associated with a lower incidence of falls, ED visits, and hospitalizations representing an important consideration for targeted physical therapist interventions.</p><p><strong>Impact statement: </strong>Physical therapists are uniquely positioned to identify and address reduced activity and participation. If activity and participation are specifically targeted and improved through physical therapy, undesirable distal health outcomes might be prevented or minimized.</p><p><strong>Lay summary: </strong>Greater activity and participation were found to be related to lower rate of falls, ED visits, and hospitalizations in a sample of 341 older adults who lived in the community.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.5000,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11485024/pdf/","citationCount":"0","resultStr":"{\"title\":\"Activity and Participation Are Associated With Future Falls, Hospitalizations, and Emergency Visits in Community-Dwelling Older Adults.\",\"authors\":\"Brooke N Klatt, Subashan Perera, Pamela M Dunlap, Andrea L Rosso, Jennifer S Brach\",\"doi\":\"10.1093/ptj/pzae087\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Activity and participation are important for older adults as they are associated with well-being and quality of life. Falls, emergency department (ED) visits, and hospitalizations are adverse health outcomes that impact older adults. Limited research has investigated whether measurement of activity and participation are related to adverse health events in community dwelling older adults. This study sought to examine the association between activity and participation with falls, ED visits, and hospitalization over 1 year in community dwelling older adults.</p><p><strong>Methods: </strong>A secondary analysis of a longitudinal clinical trial of 341 community dwelling older adults was conducted. The sample mean age was 80.9 (SD = 7.7) years and 83% were female. One-year risk of falls was associated with baseline Late Life Function and Disability Instrument (LLFDI) components of overall function and disability (frequency and limitations dimensions). Incident rate ratios (IRRs) and 95% CIs were calculated.</p><p><strong>Results: </strong>For each five-point higher score (clinically meaningful difference) in activity as measured by LLFDI-overall function (adjusted for age, race, sex, comorbidities and fall history), there was an 18% lower rate of falls (IRR = 0.82, 95% CI = 0.74-0.92), 12% reduction in hospitalizations (IRR = 0.88; 95% CI = 0.77-0.99), and 11% lower rate of emergency room visits (IRR = 0.89, 95% CI = 0.81-0.98). Greater participation as measured by the LLFDI limitations dimension was related to fewer falls (IRR = 0.93, 95% CI = 0.87-1.00) and hospitalizations (IRR = 0.91, 95% CI = 0.83-0.99).</p><p><strong>Conclusion: </strong>Greater activity and participation are associated with a lower incidence of falls, ED visits, and hospitalizations representing an important consideration for targeted physical therapist interventions.</p><p><strong>Impact statement: </strong>Physical therapists are uniquely positioned to identify and address reduced activity and participation. If activity and participation are specifically targeted and improved through physical therapy, undesirable distal health outcomes might be prevented or minimized.</p><p><strong>Lay summary: </strong>Greater activity and participation were found to be related to lower rate of falls, ED visits, and hospitalizations in a sample of 341 older adults who lived in the community.</p>\",\"PeriodicalId\":20093,\"journal\":{\"name\":\"Physical Therapy\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2024-10-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11485024/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Physical Therapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/ptj/pzae087\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Physical Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ptj/pzae087","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
摘要
目的:活动和参与对老年人非常重要,因为它们与老年人的福祉和生活质量息息相关。跌倒、急诊室就诊和住院是影响老年人健康的不良后果。对于活动和参与的测量是否与居住在社区的老年人的不良健康事件有关,研究有限。本研究旨在探讨社区老年人一年内活动和参与与跌倒、急诊就诊和住院之间的关系:对 341 名社区老年人的纵向临床试验进行了二次分析。样本的平均年龄为 80.9 岁(SD = 7.7),83% 为女性。一年的跌倒风险与晚年功能和残疾指数(LLFDI)中的总体功能和残疾(频率和限制)基线相关。计算出了发病率比(IRRs)和 95% CIs:根据 LLFDI 整体功能(已对年龄、种族、性别、合并症和跌倒史进行调整)衡量的活动得分每提高 5 分(临床意义差异),跌倒率降低 18%(IRR = 0.82,95% CI = 0.74-0.92);住院率降低 12%(IRR = 0.88;95% CI = 0.77-0.99);急诊就诊率降低 11%(IRR = 0.89,95% CI = 0.81-0.98)。以 LLFDI 限制维度衡量的更多参与与更少的跌倒(IRR = 0.93,95% CI = 0.87-1.00)和住院(IRR = 0.91,95% CI = 0.83-0.99)有关:结论:更多的活动和参与与较低的跌倒、急诊室就诊和住院率有关,是物理治疗师进行有针对性干预的重要考虑因素:物理治疗师在识别和解决活动和参与减少的问题方面具有独特的优势。如果通过物理治疗有针对性地提高活动和参与度,就可以预防或最大限度地减少不良的远端健康后果。
Activity and Participation Are Associated With Future Falls, Hospitalizations, and Emergency Visits in Community-Dwelling Older Adults.
Objective: Activity and participation are important for older adults as they are associated with well-being and quality of life. Falls, emergency department (ED) visits, and hospitalizations are adverse health outcomes that impact older adults. Limited research has investigated whether measurement of activity and participation are related to adverse health events in community dwelling older adults. This study sought to examine the association between activity and participation with falls, ED visits, and hospitalization over 1 year in community dwelling older adults.
Methods: A secondary analysis of a longitudinal clinical trial of 341 community dwelling older adults was conducted. The sample mean age was 80.9 (SD = 7.7) years and 83% were female. One-year risk of falls was associated with baseline Late Life Function and Disability Instrument (LLFDI) components of overall function and disability (frequency and limitations dimensions). Incident rate ratios (IRRs) and 95% CIs were calculated.
Results: For each five-point higher score (clinically meaningful difference) in activity as measured by LLFDI-overall function (adjusted for age, race, sex, comorbidities and fall history), there was an 18% lower rate of falls (IRR = 0.82, 95% CI = 0.74-0.92), 12% reduction in hospitalizations (IRR = 0.88; 95% CI = 0.77-0.99), and 11% lower rate of emergency room visits (IRR = 0.89, 95% CI = 0.81-0.98). Greater participation as measured by the LLFDI limitations dimension was related to fewer falls (IRR = 0.93, 95% CI = 0.87-1.00) and hospitalizations (IRR = 0.91, 95% CI = 0.83-0.99).
Conclusion: Greater activity and participation are associated with a lower incidence of falls, ED visits, and hospitalizations representing an important consideration for targeted physical therapist interventions.
Impact statement: Physical therapists are uniquely positioned to identify and address reduced activity and participation. If activity and participation are specifically targeted and improved through physical therapy, undesirable distal health outcomes might be prevented or minimized.
Lay summary: Greater activity and participation were found to be related to lower rate of falls, ED visits, and hospitalizations in a sample of 341 older adults who lived in the community.
期刊介绍:
Physical Therapy (PTJ) engages and inspires an international readership on topics related to physical therapy. As the leading international journal for research in physical therapy and related fields, PTJ publishes innovative and highly relevant content for both clinicians and scientists and uses a variety of interactive approaches to communicate that content, with the expressed purpose of improving patient care. PTJ"s circulation in 2008 is more than 72,000. Its 2007 impact factor was 2.152. The mean time from submission to first decision is 58 days. Time from acceptance to publication online is less than or equal to 3 months and from acceptance to publication in print is less than or equal to 5 months.