摘要：In 2015, the estimated cost to the US healthcare system of fatal and non-fatal falls was around US$50 billion. In our aging global
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In 2015, the estimated cost to the US healthcare system of fatal and non-fatal falls was around US$50 billion. In our aging global population, reducing the number of falls among older adults is a high priority. That is why newly published international research into a particular fall risk factor is important.
2015年，致命和非致命跌倒给美国医疗系统造成的预估成本约为500亿美元。在全球人口老龄化的背景下，减少老年人跌倒事件已成为当务之急。这正是最新发表的关于特定跌倒风险因素的国际研究具有重要意义的原因。
Researchers from Australia, the UK, Germany and Canada undertook a systematic review and meta-analysis of studies examining the association between older adults’ fear, or concerns, about falling and the incidence of future falls, and found a link.
来自澳大利亚、英国、德国和加拿大的研究人员开展了一项系统综述和荟萃分析，通过考察老年人对跌倒的恐惧或担忧与未来跌倒发生率之间的关联，发现二者存在显著相关性。
“Concerns about falling are highly prevalent in older adults, affecting nearly one in two people by age 86,” said the study’s senior author, Professor Kim Delbaere, from the Falls, Balance and Injury Research Center. “They have been linked to reduced quality of life and independence, poor rehabilitation outcomes and increased risk of frailty, disability and admission to care homes.”
该研究负责人、跌倒平衡与损伤研究中心的Kim Delbaere教授指出："对跌倒的担忧在老年人中非常普遍，86岁人群中近半数受此困扰。这种心理状态与生活质量下降、独立性丧失、康复效果差、虚弱程度加剧、失能风险增加以及入住养老院概率升高等问题密切相关。
The researchers analyzed 53 studies comprising 75,076 participants aged 60 and older. The studies explored the association between baseline concerns about falling – or related factors, such as balance confidence – and future falls over a follow-up period of at least six months.
研究团队分析了涉及75,076名60岁及以上参与者的53项研究。这些研究探讨了基线跌倒担忧（或相关因素如平衡信心）与至少6个月随访期内未来跌倒发生率之间的关系。
“Our analysis found that older adults with high concerns about falling were significantly more likely to experience a fall,” Delbaere said. “While we already knew having prior falls was a risk factor for developing concerns about falling, this research found falling can be both a cause and a consequence of falls.
Delbaere教授表示：分析显示，对跌倒存在高度担忧的老年人发生跌倒的概率显著增加。虽然我们已知既往跌倒史是产生跌倒担忧的风险因素，但此次研究发现跌倒既是引发担忧的诱因，也可能成为担忧心理导致的后果。
“Importantly, this increased risk was observed even after accounting for key physical risk factors such as age, previous falls and balance impairments. This means that concerns about falling are not just a reflection of physical frailty but an independent factor influencing future falls.” "
尤为重要的是，即使在调整了年龄、既往跌倒史、平衡障碍等关键生理风险因素后，这种风险增加仍然存在。这意味着跌倒担忧不仅是身体虚弱的表现，更是影响未来跌倒风险的独立预测因子。
The review had several limitations. There was wide variability across the studies examined, particularly in confounding variables, study inclusion and exclusion criteria, and consistency regarding the assessment of falls. The exclusion of people with significant cognitive or neurological impairments limited the generalizability of the findings.
该研究也存在若干局限性：纳入研究在混杂变量、入选排除标准、跌倒评估方法等方面存在较大异质性；排除了严重认知或神经功能障碍患者，限制了研究结果的普适性。
Nonetheless, the researchers say their findings still fill a gap in evidence and have clinical use.
尽管如此，研究者认为该成果填补了证据空白，具有临床指导价值。
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来源：三顷良田