転倒の疫学

Epidemiology of Bone and Joint Disease ～The Present and Future～. Epidemiology of falls.

　運動器疾患をターゲットとした縦断的コホート調査Research on Osteoarthritis/osteoporosis Against Disability（ROAD）の追跡調査により，高齢者における３年間の転倒発生率が男性17.4％，女性24.1％と非常に高いこと，さらには，歩行時間で評価した運動機能の低下および，特に女性においては膝痛が複数回転倒の予測因子であることが明らかになった。

　A longitudinal analysis using a population-based cohort study known as Research on Osteoarthritis/osteoporosis Against Disability（ROAD）clarified the associations of physical performance and bone and joint diseases with falls. A total of 452 men and 896 women were analyzed in the present study（mean age, 63.9 years）．A questionnaire was used to assess the number of falls during the 3-year follow-up. Grip strength, 6-m walking time, and chair stand time were measured at baseline. Knee osteoarthritis（OA）and lumbar spondylosis were defined as Kellgren Lawrence＝3 or 4. Vertebral fracture（VFx）was assessed with the Japanese Society of Bone and Mineral Research criteria. Knee and lower back pain were estimated by an interview. During a 3-year follow-up, 17.4％ men and 24.1％ women reported at least one fall. Multinomial logistic regression analysis after adjustment for age and BMI showed that a longer 6-m walking time was a risk factor for multiple falls in men and women. Knee pan was also a risk factor for multiple falls in women. Walking time and knee pain may be a simple and quick option for measuring the risk of falling.