A poor performance in comprehensive geriatric assessment is associated with increased fall risk in elders with hypertension： a cross-sectional study

作     者：Jiao-Jiao CHU Xu-Jiao CHEN Shan-Shan SHEN Xue-Feng ZHANG Ling-Yan CHEN Jing-Mei ZHANG Jing HE Jun-Feng ZHAO 

作者机构：Department of Geriatrics Zhejiang Hospital Hangzhou 310013 Zhefiang Province China Fuyuan Hospital of Yiwu Yiwu 322000 Zhejiang Province China Department of Emergency Zhejiang Hospital Hangzhou 310013 Zhejiang Province China 

出 版 物：《Journal of Geriatric Cardiology》 (老年心脏病学杂志（英文版）)

年 卷 期：2015年第12卷第2期

页      面：113-118页

核心收录：

学科分类：0710[理学-生物学] 1007[医学-药学(可授医学、理学学位)] 071010[理学-生物化学与分子生物学] 081704[工学-应用化学] 07[理学] 08[工学] 0817[工学-化学工程与技术] 10[医学] 

基　　金：ZhejiangMedicalScienceandTechnologyProject(GrantsWKJ2013-2-001,2013KYA006) TheZhejiangScienceandTechnologyDepartmentPublicWelfareSocialDevelopmentProject(2014C33241) 

主　　题：Comprehensive geriatric assessment Elderly patient Fall risk Hypertension 

摘      要：Background Fall and serious fall injuries have become a major health concern for elders. Many factors including blood pressure and anti-hypertensive medication application were reported as hazards of fall. The purpose of this study was to determine if age related systemic functional decline related with increased fall risks in elderly patients with hypertension. Methods A total of 342 elderly hypertension patients （age 79.5 ＋ 6.7 years, male 63.8%） were recruited to the study. Comprehensive geriatric assessment （CGA）, including measurements about activity of daily living （ADL）, nutrition, cognition, depression, numbers of prescription medication and number of clinical diagnosis, was conducted to evaluate the physical and mental status of each participants. Fall risk was evaluated by Morse fall scale, Tinetti perform- ance oriented mobility assessment （POMA） and history of fall in the recent years. Participants were grouped into tertiles according to CGA score. Correlation between CGA and fall risk was analyzed through SPSS 18.0. Results Participants with higher CGA score were likely to be older, had a lower body mass index （BMI）, and a higher prevalence of cardiovascular disease, chronic obstructive pulmonary disease （COPD）, cerebrovascular disease and osteoarthropathia. Participants in higher tertile of CGA score got increased prevalence of fall risk than those in lower tertile （P 〈 0.01 T3 vs. T1, P 〈 0.01 T3 vs. T2）. Correlation analysis and regression analysis showed significant association between CGA and Morse fall scale （P 〈 0.001）, as well as CGA and POMA （P 〈 0.001）. Meanwhile, CGA components also showed co-relationships with increase fall risks. After adjusting age, BMI, benzodiazepine use, cardiovascular disease, cerebrovascular disease, COPD and osteoarthropathia, both history of fall in the recent year and rising Morse fall scale were significantly associated with ADL im- pairment （OR： 2.748, 95%CI： 1.598-4.725）, （OR： 3.310, 95%CI： 1.893-5.788）. Decreas