Abstract:

Objective To explore latent classes of intrinsic capacity in older adults and analyze the role of different latent classes in influencing the occurrence of falls in older adults. Methods A convenience sampling method was utilized to select the older adults in a community in Beijing in November-December 2020 as the survey respondents. General Information Questionnaire and WHO Intrinsic Capacity Assessment Tool were used to collect information，and the study participants were followed up in June-July，2023. Potential classes were analyzed using Mplus 8.0 software，and logistic regression was used to analyze the effect of potential classes of intrinsic capacity on falls. Results Follow-up was completed by 243（85.6%） survey respondents，with a decrease in the follow-up intrinsic capacity score from baseline（Z=4.667，P<0.001），and 30（12.3%） older adults had experienced falls in the last 1 year. The intrinsic capacity of the older people can be clustered into 3 potential classes，namely，the low level of perception group（69.7%），the low level of cognition and perception group（23.2%），and the medium level of cognition and low level of vitality，psychological and perception group（7.1%）. Logistic regression results showed that the risk of falling in the group with the medium cognition and low vitality，psychological and perception is 5.777 times（95%CI：1.824-18.298） higher than that in the group with low perception，and the risk of falling in the group with medium cognition and low vitality，psychological and perception is 7.534 times（95%CI：1.822-31.150） higher than that in the group with low cognition and perception. Conclusion The prevalence of falls in the older adults is high；the intrinsic capacity is heterogeneous；potential classes of intrinsic capacity play different roles in the degree to which they predict the risk of falls. It is recommended to pay attention to the heterogeneity of intrinsic capacity of older adults in clinical work and to take targeted measures to prevent falls.

Key words: Aged, Intrinsic Capacity, Falls, Latent Class Analysis, Cohort Study, Questionnaire, Nursing Care

摘要：

目的 探讨老年人内在能力的潜在类别，并分析不同潜在类别对老年人跌倒发生的影响作用，为有效地预防老年人跌倒提供参考。方法 采用便利抽样法，选取2020年11月—12月北京市某社区老年人为调查对象。采用一般资料调查问卷、WHO内在能力评估工具收集资料，并于2023年6月—7月对调查对象进行随访。应用Mplus 8.0软件对收集的数据进行潜在类别分析，采用Logistic回归分析老年人内在能力潜在类别对跌倒的影响。结果 共调查了284名老年人，243名完成随访，有效随访率为85.6%。随访老年人内在能力得分与基线比较有所下降（Z=4.667，P<0.001），有30名（12.3%）老年人在近1年内发生过跌倒。老年人内在能力可聚类为3个潜在类别：低水平感知觉组（69.7%），低水平认知与感知觉组（23.2%），中等水平认知与低水平活力、心理及感知觉组（7.0%）。Logistic回归分析结果显示，中水平认知与低水平活力、心理及感知觉组跌倒发生风险是低水平感知觉组的5.777倍（95%CI：1.824~18.298），中水平认知与低水平活力、心理及感知觉组跌倒发生风险是低水平认知与感知觉组的7.534倍（95%CI：1.822~31.150）。结论 老年人跌倒发生率高，且其内在能力具有异质性，内在能力的潜在类别对跌倒的预测风险程度不同。建议在临床工作中关注老年人内在能力的异质性，采取针对性措施以防范跌倒事件的发生。

关键词: 老年人, 内在能力, 跌倒, 潜在类别分析, 队列研究, 问卷调查, 护理