老年人中休闲步行与室内外跌倒关联的性别差异——健康老龄化与邻里研究（HANS）
Gender differences in the associations of recreational walking with indoor and outdoor falls among older adults-the Healthy Aging and Neighborhood Study (HANS).
作者信息
Chen Lingming, Procter-Gray Elizabeth, Le Qun, LoPilato Danielle, Ferretto Marianella, Kane Kevin, Hannan Marian T, Berry Sarah, Li Wenjun
机构信息
Department of Public Health and Center for Health Statistics, University of Massachusetts Lowell, 61 Wilder St, Lowell, MA 01854, USA.
Marcus Institute for Aging Research, Hebrew SeniorLife, 1200 Centre Street, Boston, MA 02131, USA.
出版信息
AIMS Public Health. 2025 Feb 8;12(1):185-201. doi: 10.3934/publichealth.2025012. eCollection 2025.
OBJECTIVE
This study examined gender differences in the association between recreational walking and indoor and outdoor fall rates among older adults.
METHODS
The Healthy Aging and Neighborhood Study is a prospective cohort that included 716 community-dwelling adults aged 65-95 years in central and northeastern Massachusetts, USA (2018-2023). Recreational walking at baseline was measured by the frequency of walking for exercise for at least 10 min in the participants' neighborhood. Falls were reported on monthly falls calendars, and the circumstances for reported falls were collected via subsequent telephone interviews. Mixed effects negative binomial models were used to estimate gender differences in the associations of recreational walking with rates of indoor and outdoor falls, separately. Models were adjusted for sociodemographic variables, physical health, functional status, lifestyle behaviors, mental health, and fear of falling.
RESULTS
There were 394 (55%) female and 322 (45%) male participants enrolled in the study, and the () age was 74.08 (6.29). About 61% of participants engaged in recreational walking at least once weekly. Women had lower outdoor fall rates than men (32 . 40 per 100 person-years), while indoor fall rates did not significantly differ by gender (31 . 34 per 100 person-years). Women engaging in recreational walking at least once weekly had a 62% lower indoor fall rate [IRR (95% ): 0.38 (0.21, 0.71)] than those who did not. No significant associations were observed between recreational walking and outdoor falls for both women and men.
DISCUSSION
Among community-dwelling older women, but not men, a higher frequency of recreational walking was associated with lower rates of indoor falls, while no changes were seen with outdoor falls. Increasing recreational walking may be a viable focus for fall prevention programs in the community, especially for older women.
目的
本研究探讨了老年人休闲散步与室内外跌倒发生率之间关联的性别差异。
方法
健康老龄化与邻里研究是一项前瞻性队列研究，纳入了美国马萨诸塞州中部和东北部716名年龄在65 - 95岁的社区居住成年人（2018 - 2023年）。基线时的休闲散步情况通过参与者在其邻里社区进行至少10分钟锻炼性步行的频率来衡量。跌倒情况记录在每月的跌倒日历上，并通过后续电话访谈收集所报告跌倒的相关情况。采用混合效应负二项模型分别估计休闲散步与室内外跌倒发生率关联中的性别差异。模型对社会人口统计学变量、身体健康状况、功能状态、生活方式行为、心理健康状况以及跌倒恐惧等因素进行了调整。
结果
该研究共纳入394名女性（55%）和322名男性参与者（45%），平均年龄为74.08岁（6.29岁）。约61%的参与者每周至少进行一次休闲散步。女性的室外跌倒发生率低于男性（每100人年32.40次），而室内跌倒发生率在性别上无显著差异（每100人年31.34次）。每周至少进行一次休闲散步的女性室内跌倒发生率比不进行休闲散步的女性低62% [发病率比（95%置信区间）：0.38（0.21，0.71）]。在男性和女性中，均未观察到休闲散步与室外跌倒之间存在显著关联。
讨论
在社区居住的老年女性中，而非老年男性中，较高频率的休闲散步与较低的室内跌倒发生率相关，而室外跌倒发生率未见变化。增加休闲散步可能是社区预防跌倒项目的一个可行关注点，特别是对于老年女性。
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