臺灣南部某一社區男性老人跌倒盛行率及相關因子之研究

The Prevalence of and Factors Associated with Falls by Elderly Rural Males

目的：以高雄市田寮區65歲以上男性為對象，調查男性跌倒盛行率及其危險因子，為老人跌倒的防治提供參考。方法：於2009年7月12日至2009年7月29日間，針對設籍在高雄市田寮區1,033位65歲以上男性為研究抽樣對象，共414位接受檢查，完成率為60.8%。每位研究對象皆須接受由訓練良好的工作人員面對面訪談方式完成結構式問卷的內容，經扣除資料不完整者實際進入分析研究對象為413人。完成檢查者（413人）之平均年齡為74.6±6.2歲，未完成檢查者（620人）之平均年齡為74.9±6.5歲，兩者在年齡上並無顯著差異(p>0.05)。結果：在413位受檢者中，過去一年之中曾跌倒的男性有78位(18.9%)，共發生167次跌倒，跌倒地點以室外佔大部分為62.3%。其中室外以菜園農地(26.8%)、街道或路上(21.5%)佔大多數；室內則以庭院(16.7%)及樓梯(13.3%)居多。以跌倒與相關危險因子進行單變項的分析，結果發現年齡(p=0.016)、喝咖啡習慣(p=0.036)、自評健康狀況(p=0.016)、糖尿病病史(p=0.013)及開刀經驗(p=0.017)方面有明顯差異。進一步以邏輯複回歸模式分析，則開刀經驗及糖尿病病史與跌倒呈正相關；而年齡及自評健康狀況則與跌倒呈負相關。結論：本研究顯示偏遠地區老年男性跌倒之盛行率為18.9%。而其中年齡較低、自評健康狀況較差、有糖尿病病史者、有開刀經驗者，均是跌倒的獨立危險相關因子。

Aims: To determine the prevalence of and risk factors for falls among elderly rural males and to provide suggestions for the prevention of falls. Methods: Subjects were recruited from 1033 elderly people aged 65 years and older in Tianliao District, Kaohsiung City during July 12 to 29, 2009. Of these, 414 residents (60.8%) responded. Each subject was interviewed face-to-face by well-trained interviewers who completed the structure questionnaire. Data from one subject were incomplete, so 413 subjects were entered into the analysis. There was no significant difference (p>0.05) in average age between the 413 responders (average age: 74.6±6.2) and the 620 non-responders (average age: 74.9±6.5). Results: Of the 413 men, 78 (18.9%) had fallen in the preceding year for a total of 167 separate incidents. Of the 167 falls, 62.3% were outdoors: 26.8% in farmland and 21.5% on sidewalks. Indoors, falls were mostly in courtyards (16.7%) and on stairs (13.3%). Univariate analyses showed that significant risk factors were age (p=0.016), the habit of drinking coffee (p=0.036), self-perceived health status, a history of diabetes mellitus (p=0.013) and a history of previous surgery (p=0.017). Multiple logistic regression analysis showed that the experience of surgery and a history of diabetes mellitus were positively associated with the risk of falling and age and self-perceived health status were negatively associated with that risk. Conclusions: This study showed that the prevalence of falls among elderly rural males was 18.9%. Being younger, having worse self-perceived health status, a history of diabetes mellitus and a history of previous surgery were independent risk factors associated with falls.