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Demenz, Depressionen und Aktivitäten des täglichen Lebens als Risikofaktoren von Stürzen bei Betagten

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Sozial- und Präventivmedizin

Summary

Objectives

Falls among elderly are a well-recognised public health problem. The purpose of the present study was to explore the relation between dementia, number of depressive symptoms, activities of daily living, setting, and risk of falling.

Methods

Data for the analysis came from a cross-sectional study about dementia, depression, and disabilities, carried out 1995/96 in Zurich and Geneva. The random sample stratified, by age and gender consisted of 921 subjects aged 65 and more. The interview was conducted by means of the Canberra Interview for the Elderly, extended by short questionnaire. The subject was classified as a faller if the subject and/or the informant had reported a fall within the last 12 months prior to the interview. Logistic-regression analysis was used to determine the independent impact of dementia, depressive symptoms, and ADL-score on risk of falling.

Results

The stepwise logistic regression analysis has revealed a statistically significant association between dementia (OR 2.14, 95% Cl 1.15–3.96), two resp. three depressive symptoms (OR 1.64, 95% Cl 1.04–2.60) as well as four or more depressive symptoms (OR 2.64, 95% Cl 1.39–5.02) and the risk of falling. There was no statistically significant relationship between studied risk factors and the risk of being one-time faller. However, we found a strong positive association between dementia (OR 3.92, 95% Cl 1.75–8.79), four or more depressive symptoms (OR 3.90, 95% Cl 1.55–9.83) and the risk of being recurrent faller. Moreover, residents of nursing homes (OR 8.50, 95% Cl 2.18–33.22) and elderly aged 85 or more (OR 2.29, 95% Cl 1.08–4.87) were under statistically significant higher risk of sustaining recurrent falls.

Conclusions

The results of the present study confirm that dementia and depression substantially increase the risk of falling.

Zusammenfassung

Fragestellung

Stürze bei Betagten werden als bedeutendes Public-Health-Problem anerkannt. Im Mittelpunkt der Studie steht das Ziel, anhand eines repräsentativen Kollektivs von Betagten der Städte Zürich und Genf die Beziehungen zwischen Demenz, Anzahl der depressiven Symptome, Aktivitätten des täglichen Lebens sowie der Wohnsituation und dem Sturzrisiko zu eruieren.

Methoden

Ausgangspunkt der Analysen waren Daten aus einer Querschnittsstudie über Demenz, Depressionen und Behinderungen im Alter, die 1995/96 in Zürich und Genf durchgeführt wurde. Die nach Alter und Geschlecht geschichtete Stichprobe bestand aus 921 Probanden. Bei der Befragung wurde das Canberra Interview for the Elderly (CIE) verwendet, ergänzt durch einen kurzen Fragebogen. Ein Proband wurde als Gestürzter klassifiziert, wenn er und/oder der jeweilige Informant einen Sturz innerhalb der letzten 12 Monate angab. Die statistischen Auswertungen erfolgten mittels der multivariaten logistischen Regressionsanalyse.

Ergebnisse

Die Analysen zeigen eine statistisch signifikante Assoziation zwischen Demenz (OR 2,14; 95%-KI 1,15–3,96), zwei bzw. drei depressiven Symptomen (OR 1,64; 95%-KI 1,04–2,60) sowie vier oder mehr depressiven Symptomen (OR 2,64; 95%-KI 1,39–5,02) und dem Sturzrisiko. Es ergeben sich einerseits keine signifikante Relationen zwischen Demenz, Anzahl der depressiven Symptome sowie ADL und einmaligem Sturz. Anderseits besteht in der schrittweisen logistischen Analyse eine starke statistisch signifikante positive Assoziation zwischen Demenz (OR 3,92; 95%-KI 1,75–8,79), vier oder mehr depressiven Symptomen (OR 3,90; 95%-Kl 1,55–9,83) und rezidivierenden Stürzen. Bewohner der Pflegeheime (OR 8,50; 95%-Kl 2,18–33,22) und Betagte über 85 Jahre alt (OR 2,29; 95%-Kl 1,08–4,87) haben ein erhöhtes Risiko, rezidivierende Stürze zu erleiden.

Schlussfolgerungen

Die Resultate der Studie bestätigen, dass Demenz und Depressionen das Sturzrisiko bei Betagten wesentlich zu erhöhen vermögen.

Résumé

Objectifs

Les chutes parmi âgé sont un problème de santé publique bien reconnu. Le but de l'étude présente était d'explorer la relation entre la démence, le numéro de symptômes dépressifs, les activités de vie quotidienne, l'arrangement et le risque de chute.

Méthodes

Les données pour l'analyse sont venues d'une étude mutuelle-à éléments de la démence, la dépression et des handicaps, effectués 1995/96 à Zurich et Genève. Un échantillon aléatoire stratifié, à l'âge et le genre a consisté en 921 sujets âgé 65 et plus. L'interview a été conduit au moyen de Canberra l'Interview pour l'Âgé, prolongé par le questionnaire court. Le sujet a été classifié comme un chuteur si le sujet et-ou l'informateur avaient annoncé une chute dans les 12 derniers mois avant l'interview. L'analyse de régressions logistiques multiple a été employée pour déterminer l'impact indépendant de démence, des symptômes dépressifs et l'ADL-score en risque de chute.

Résultats

L'analyse de régression point par point logistique a révélé l'association statistiquement significative entre la démence (OU 2,14; 95% CI 1,15–3,96), deux resp. trois symptômes dépressifs (OU 1,64; 95% CI 1,04–2,60) aussi bien que quatre symptômes ou plus dépressifs (OU 2,64; 95% CI 1,39–5,02) et le risque de chute. Il n'y avait pas statistiquement le rapport significatif entre des facteurs de risque étudiés et le risque d'être le chuteur jetable. Cependant, nous avons découvert une association forte positive entre la démence (OU 3,92; 95% CI 1,75–8,79), quatre symptômes ou plus dépressifs (OU 3,90; 95% CI 1,55–9,83) et le risque d'être le chuteur récurrent. De plus, les résidants de maisons de repos (OU 8,50; 95% CI 2,18–33,22) et âgé 85 ou plus (OU 2,29; 95% CI 1,08–4,87) étaient statistiquement significatifs plus haut le risque de supporter des chutes récurrentes.

Conclusions

Les résultats de l'étude présente ont confirmé que la démence et la dépression augmentent considérablement le risque de chute.

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Authors and Affiliations

  1. Institut für Sozial-und Präventivmedizin der Universität Zürich, Zürich, Deutschland

    Michal Gostynski MPH, Vladeta Ajdacic-Gross, Rolf Heusser-Gretler & Felix Gutzwiller

  2. Département de gériatrie, Hôpitaux Universitaire de Genève, Genève, Schweiz

    Jean-Pierre Michel & François Herrmann

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  1. Michal Gostynski MPH
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  2. Vladeta Ajdacic-Gross
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  4. Felix Gutzwiller
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Gostynski, M., Ajdacic-Gross, V., Heusser-Gretler, R. et al. Demenz, Depressionen und Aktivitäten des täglichen Lebens als Risikofaktoren von Stürzen bei Betagten. Soz Präventivmed 46, 123–130 (2001). https://doi.org/10.1007/BF01299729

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