在宅要介護高齢者における床上動作能力と転倒恐怖感の因果関係の推定

Estimating the causal effects of fear of falling and ability to sit on the floor of frail elderly at home

要旨：本研究の目的は，要介護高齢者の床上動作能力と転倒恐怖感の因果関係の推定を縦断研究で確認することである．2年間追跡可能であった床上動作能力を有する在宅要介護高齢者33名（男性16名，女性17名）を 対象とし，Timed“Up and Go”Test，床起立能力，床着座能力と転倒恐怖感の因果関係について，共分散構造分析による交差遅れ効果モデルと同時効果モデルの2つのモデルを用いて検討した．その結果，床着座能力が転倒恐怖感に影響する要因であることが示された．床上動作能力を有する要介護高齢者においては，床着座能力を保つことが転倒恐怖感の軽減につながる可能性が示唆された．

　The purpose of this study was to elucidate the causal relationship between fear of falling and the ability of the elderly to sit on the floor at home through a two-year longitudinal study. The subjects were 33 frail elderly living at home (16 males and 17 females) who regularly used day-care facilities. Interviews and physical measurements were conducted. Interviews investigated the Falls Efficacy Scale Japanese edition (FES). Regarding physical measurements, the Timed“Up and Go”Test (TUG) was used to assess functional mobility. The elapsed time subjects took to 1）stand up from prolonged sitting on the floor, and 2）sit down for a prolonged period on the floor from a standing position was used to assess ability to sit on the floor. TUG, ability to sit on the floor and FES were compared by cross-lagged and synchronous effect models in the structural equation model. The time subjects took to sit on the floor correlated with the subjects' fear of falling. The results indicate an increased ability sit on the floor reduces the fear of falling in frail elderly.