Epidemiological Characteristics Of Fall-related Injuries Among The Elderly In Guangzhou And Community Intervention Trials On Baduanjin In Improving Balance

Objectives1.To analyze the epidemiological characteristics of unintentional fall in elderly in Guangzhou.To explore related factors with elderly unintentional fall.2.To evaluate Baduanjin role in improving the balance of elderly woman,reducing the risk of falls in elderly,and to provide data for scientific and effective interventions.Methods1.The unintentional fall-related injury data of elderly aged 60 years and above was analyzed from the injury surveillance hospitals in Guangzhou from 2014 to 2016.Descriptive epidemiological analysis was conducted toshow characteristics of demography and unintentional fall in elderly.2.Spearman’s correlation and Logistic regression analysis were used to identify the risk factors for fall injuries.3.A total of 122 casesof voluntary participants aged from 60 to 80 were screened in this study in Panyu community of Guangzhou.The participants were randomly assigned to the trail group and the control group by community,61 cases in each group.In trail group conducted Baduanjin exercise,while in control group conducted health education,both intervene for 6 months.All subjects are evaluated for balance ability by using the Berg Balance Scale,Tinettiti Balance Scale,one-leg standing timetest,strengthening Romberg’s test and Timed up and go test(before and after intervention for 3 months and 6 months respectively).Generalized Estimating Equation approach was used to analysis the effective in improving balance in older people.Results1.Characteristics of fall-related injuries among the elderly in GuangzhouA total of 4451 fall case were reported in people aged ≥60 years in Guangzhou from 2014 to 2016,accounting for 50.80%of total unintentional injuries in this population.The sex ratio of male to female was 1:1.67 and the proportion of females increased with age.The peak months and seasons of the elder fall were October to December(9.44%,9.44%,9.86%)and autumn(27.68%).The top two places where fall might occur were home(73.58%)and roads/streets(14.24%).Living activities(35.05%),and leisure activity(28.08%)were the major cause of elderly unintentional fall.The common injury body parts were head(38.96%),low limbs(27.39%),while the common injuries caused by fall were bruise(48.51%),and fractures(30.67%).The fall injuries mainly cause mild(62.39%)and moderate(33.34%)injury.67.60%elderly fall patients went home after treatment,32.11%elderly of them needed to stay in hospital for observation,hospitalization or transferring to another hospital.2.The risk factors for fall injuries among the elderly in GuangzhouDaily wind speed,pressure and rainfall were significantly and positively correlated with the number of daily elderly unintentional fall-related injuries cases(p values<0.01),while average daily temperature and sunshine hours were significantly but negatively correlated with daily elderly unintentional fall-related injuries(p values<0.01).Female(OR=1.25,95%CI:1.14-1.37),the 70-year-old or older(OR=2.20,95%CI:1.98-2.45),immigrants(OR=1.20,95%CI:1.02-1.41),and average temperature below 13 degrees C(OR=1.33,95%CI:1.15-1.55)were the risk factors for fall.The elderly aged 70 years and above(OR=1.48,95%CI:1.13-1.94),living activities(OR=1.47,95%CI:1.04-2.07),walk(OR=1.83,95%CI:1.25-2.69)and work(OR=2.87,95%CI:1.30-6.35),low limbs(OR=3.33,95%CI:2.37-4.69),head(OR=3.12,95%CI:2.06-4.73),truncus(OR=2.49,95%CI:1.69-3.69)and multi-parts of body(OR=3.63,95%CI:2.17-6.07),fracture(OR=2.53,95%CI:1.84-3.50),concussion/cerebral contusion(OR=2.93,95%CI:1.86-4.62)were the risk factors of hospitalization or death(p values<0.05).3.Balance changes before and after interventionA total of 120 cases of elderly completed all data collection,which the trail group 61 cases,control group 59 cases(two cases excluded).The mean age of all subjects was 69.85±4.96,and the rate of falls was 10.83%during a year.Balance of 60-69 age group was higher than ≥70 age group in intervention before.After 6 months intervention,the Berg balance test score of the trial group(52.66)is higher than the control group(49.00),the difference was statistically significant(p values<0.001),and the OR was 17.921(95%CI:8.02-38.48).After 3 months ntervention,the scores of Berg balance test(p values<0.001),Eye opened strengthening Romberg’s test(p values<0.001)and Eye closed left one-leg standing time test(p values=0.025)of the trial group is higher than the intervention before,After 6 months intervention,the scores of Berg balance test(p values<0.001),Tinetti test(p values<0.001),Eye opened one-leg standing time test(p values<0.005),Eye opened strengthening Romberg’s test(p values<0.001)and Timed up and go test(p values<0.001)of the trial group is higher than the intervention before.After 6 months intervention,the scores of Tinetti test is higher than after intervention 3 months(p values=0.028).After 6 months intervention,the improved scores of Berg balance test,Tinetti test,and Timed up and go test of the trial group is higher than after intervention 3 months(p values<0.05).Conclusion1.Fall is the major cause of unintentional injury in old population in Guangzhou.Older women have an increased risk of fall.2.Baduanjin can improve balance ability of community elderly women,and with long-term exercise its effect will more clearly.Therefore,it can be widely practiced by the elderly women in the community.