An Analyses On Mental Disorders In Older People After Fall And Its Influence Factors

Objective To explore the prevalence and its influence factors of mental disorders in older people after fall, include fear falls again (Fear of Falling) and post traumatic stress disorder (PTSD), analyze the influence degree of the elderly'activities of daily living and the harmfulness of older people's quality of life after fall, provide the basis for helping the elderly had ever fallen to overcome the fear of falling and preventing it from developing into PTSD.Methods Combining cross sectional study with mathematical model, the people over the age of 60 were investigated by structured interview survey with the method of questionnaire survey. Respectively in a community of Guangzhou and old folk's homes of Hengyang in Hunan Province, we adopted the method of purposive sampling, conducted a study on the status, the prevalence of mental disorders in various degree and quality of life for falls of 476 old persons through household surveys and on-site inquiries, analyzed the influence factors of mental disorders in various degree and the association with quality of life in older people after fall, moreover, proposed appropriate prevention and intervention strategies. With the retest reliability and internal consistency reliability (Cronbach's a coefficient) to evaluate the reliability of the self-design scale, with the standard validity, discriminant validity and construct validity to evaluate the validity of the self-design scale, logistic regression analysis and classification tree analysis were used to analyze the related factors of mental disorders in various degree.Results FFS score showed that there were 57.6% older people suffering from FFS after fall (average score 22.95±11.32), there were significant differences in people who were different age groups'attack rate of FFS after fall (χ2=40.59, P=0.000); Classification tree showed that decreased activity, quality of life score was lower 25 and needing crutch were risk factors of FFS, not decreased activity after fall and IES score was lower 14 were protective factors. The results of logistic regression analysis showed that older age, decreased activity after fall, needing crutch, suffering from PTSD and two or more chronic diseases were risk factors of FFS after fall; while the medical forms of health insurance was protective factor.IES score showed that there were 10.3% older people suffering from PTSD after fall (average score 15.10±10.45), there were significant differences in people who were different age groups'attack rate of PTSD after fall (χ2=7.47, P=0.024); Classification tree showed that decreased activity and needing someone to lift up were risk factors of FFS, not decreased activity after fall was protective factor. The results of logistic regression analysis showed that needing someone to lift up and suffering from FFS were risk factors of PTSD after fall; while the quality of life score was 25 or more was protective factor.There were 58.2% older people suffering from FFS after fall in community (FFS average score 22.29±10.25), while 56.8% older people suffering from FFS after fall in old folk's homes (FFS average score 23.97±12.79), there were no significant differences between their attack rates (χ2=0.06, P=0.814).There were 8.2% older people suffering from PTSD after fall in community (IES average score 16.07±9.52), while 13.6% older people suffering from PTSD after fall in old folk's homes (IES average score 13.58±11.64), there were no significant differences between their attack rates too (χ2=2.28, P=0.131).Conclusion There is a high incidence of mental disorders after fall among the elderly, nearly 60% older people suffering from FFS and one of ten older people suffering from PTSD after fall. The risk factors of mental disorders after fall among the elderly are higher IES score, lower quality of life score, poor health, needing crutch, older age and decreased activity, needing someone to lift up after fall.