Article

OBJECTIVE: To determine whether instrumental activity of daily living (IADL)
limitation stages can distinguish among elderly, community-dwelling persons with
high likelihoods to have fallen once and more than once. DESIGN: A cross-sectional survey. SETTING: A nationally representative sample from the
Second Longitudinal Study of Aging (LSOA II). PARTICIPANTS: Included were 7401
community-dwelling persons 70 years of age and older. METHODS: The association of
falling once and more than once within the past 12 months and 5 stages of
increasing IADL limitation were explored by using a multinomial logistic
regression model that controlled for demographics, education, perceived lack of
home accessibility features, and health conditions. Sample proportions were
weighted to reflect the prevalence in the U.S. population of 1994. MAIN OUTCOME
MEASUREMENTS: Subject recall of fall history. There were 3 categories for this
variable: no fall, falling once, and falling more than once in the past 12
months. RESULTS: Compared with IADL stage 0, the adjusted relative risk ratio of
falling once peaked in individuals at IADL stage II at 2.0 (95% confidence
interval [CI], 1.5-2.6), and those at IADL stage III had a relative risk ratio of
1.8 (95% CI, 1.3-2.6). The relative risk ratio of falling more than once was 2.1
(95% CI, 1.7-2.6), 4.0 (95% CI, 3.0-5.3), 3.7 (95% CI, 2.8-5.0), and 2.7 (95% CI,
1.5-4.9) for IADL stages I, II, III, and IV, respectively, when treating IADL
stage 0 as reference. CONCLUSIONS: IADL limitation stages could represent a
powerful and practical tool for screening patients in the U.S. elderly population
according to fall risk. Clinical implementation and prospective testing for
validation as a screening tool would be necessary.
CI - Copyright (c) 2014 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.
- Chute

Langue : ANGLAIS