痴呆症护理研究和心理社会因素
Mukaila A Raji1, Sheheryar Ali1, Yong Shan1
1University of Texas Medical Branch, Galveston, TX, USA.
Alzheimer's & dementia : the journal of the Alzheimer's Association
|December 25, 2025
概括
年度健康访问 (AWVs) 与阿尔茨海默氏症和相关痴呆症 (ADRD) 的老年人中较少的跌倒和骨折有关. 更频繁的 AWV 显著降低了跌倒风险,突出了它们在预防性护理中对这一群体的重要性.
科学领域:
- 老年学是一门学科.
- 公共卫生 公共卫生
- 神经学 神经学
背景情况:
- 跌倒和骨折是阿尔茨海默病和相关痴呆症 (ADRD) 的老年人残疾和死亡的主要原因.
- 自2011年以来由医疗保险补偿的年度健康访问 (AWV) 提供了一个管理跌倒和骨折风险的框架.
- 这项研究调查了 AWV 与预防患有 ADRD 的医疗保险受益人中跌倒和骨折之间的关联.
研究的目的:
- 评估年度健康检查 (AWV) 与预防跌倒和骨折之间的关联.
- 确定 AWV 的频率是否会影响 ADRD 的医疗保险受益人中跌倒和骨折的风险.
- 评估持续AWV参与对降落和骨折风险降低的影响.
主要方法:
- 对1610637名年龄≥68岁,患有ADRD的医疗保险受益者队列的分析,从2014年至2016年连续注册.
- 基于2017年前三年访问频率 (0,1,2,或≥3次访问) 的AWV接收者的分层.
- 利用卡普兰-梅尔方法和反向概率治疗权重 (IPTW) 与Cox比例危险模型中的倾向分数来评估结果.
主要成果:
- 增加AWV频率与降低跌倒 (HR:0.963对于≥3个AWV) 和骨折 (HR:0.959对于≥3个AWV) 的风险有关.
- 观察到降低跌倒风险的剂量反应关系,≥3个AWV的降低率为3.7%,而1个AWV的降低率为1%.
- 将AWV视为时间依赖的共变量显示,在跌倒 (HR:0.921) 和骨折 (HR:0.929) 两种情况下,风险降低更为显著.
结论:
- 年度健康访问 (AWVs) 与ADRD的老年人中跌倒和骨折的风险明显降低.
- 高频率的AWV与降落风险的较大降低相关,持续的接触进一步增强了这些保护作用.
- 提高公众对 AWV 的认识和使用对于 ADRD 患者的跌倒和骨折预防策略至关重要.
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