| 陈安邦,仇子钰,陈慧敏,等.中老年早期脑小血管病人群步态与跌倒的相关性研究[J].中国临床保健杂志,2025,28(4):514-519. |
| 中老年早期脑小血管病人群步态与跌倒的相关性研究 |
| Study on the correlation between gait and falls in elderly patients with early cerebral small vessel disease |
| 投稿时间：2025-07-05 |
| DOI：10.3969/J.issn.1672-6790.2025.04.015 |
| 中文关键词: 脑血管障碍 步态分析 意外跌倒 人工智能 |
| 英文关键词: Cerebrovascular disorders Gait analysis Accidental falls Risk factors Artificial intelligence |
| 基金项目:国家卫生健康委员会专项课题(2022YB05) |
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| 中文摘要: |
| 目的 探讨中老年早期脑小血管病(CSVD)人群步态特征与跌倒事件的相关性。方法 前瞻性、观察性、纵向研究。自2017年5月至2019年9月,PRECISE研究共招募来自浙江省丽水市的6个村庄和4个社区居民符合标准的3 067例中老年人。本研究共纳入PRECISE队列中934例基线符合早期CSVD的中老年人群,早期CSVD人群的定义为CSVD负荷评分≥1分。使用基于人工智能的步态定量分析系统(ReadyGo)定量采集步态参数,随访2年,并记录受试者2年内跌倒情况。采用组间比较观察跌倒组与未跌倒组的临床资料与步态参数差异,使用logistic回归后退法分析筛选跌倒的危险因素,校正混杂因素并通过敏感性分析验证结果的稳健性。结果 共771例受试者完成随访,其中61例发生跌倒。早期CSVD伴跌倒组较不伴跌倒组摆动速度较慢、步频较快、步高较低(P<0.05)；2组间蒙特利尔认知评估评分差异无统计学意义(P>0.05)。女性(OR=2.29,95%CI:1.10~4.78,P=0.027)、既往缺血性卒中史(OR=3.32,95%CI:1.22~9.06,P=0.019)、跨步速度慢(OR=0.60,95%CI:0.42~0.87,P=0.007)、步频快(OR=1.56,95%CI:1.08~2.25,P=0.019)是跌倒发生的危险因素。结论 中老年早期CSVD人群的慢跨步速度、快步频等步态参数与高跌倒风险相关。 |
| 英文摘要: |
| Objective To explore the correlation between gait characteristics and fall events in middle-aged and elderly community-dwelling individuals with early cerebral small vessel disease (CSVD).Methods Prospective,observational,longitudinal follow-up study.From May 2017 to September 2019,the PRECISE study recruited a total of 3,067 eligible middle-aged and elderly individuals from six villages and four communities in Lishui City,Zhejiang Province.This study included a total of 934 middle-aged and elderly individuals from the PRECISE cohort who met the baseline criteria for early CSVD,defined as a CSVD burden score of ≥1.Gait parameters were quantitatively collected using an artificial intelligence-based gait quantitative analysis system (ReadyGo).Subjects were followed up for 2 years,and fall incidents within the 2-year period were recorded.Clinical data and gait parameters were compared between the fall and non-fall group.Logistic regression with backward selection was used to identify risk factors for falls,with adjustment for confounders.Sensitivity analysis was performed to validate the robustness of the results.Results A total of 771 subjects completed the follow-up,61 experienced falls during the study.Compared with the non-fall group,the fall group with early CSVD had slower swing velocity,faster step frequency,and lower step height (P<0.05).However,there was no significant difference in MoCA scores between groups (P>0.05).Female sex (OR=2.29,95%CI:1.10-4.78,P=0.027),history of ischemic stroke (OR=3.32,95%CI:1.22-9.06,P=0.019),slow stride velocity (OR=0.60,95%CI:0.42-0.87,P=0.007),and fast step frequency (OR=1.56,95%CI:1.08-2.25,P=0.019) were identified as risk factors for falls.Conclusions In middle-aged and elderly individuals with early CSVD,gait parameters such as slow stride velocity and fast step frequency are associated with a higher risk of falls. |
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