老年眩晕、头晕和平衡障碍患者对治疗建议的依从性：MobilE-TRA 2队列研究。
Adherence to treatment recommendations in older adults with vertigo, dizziness, and balance disorders: the MobilE-TRA 2 cohort study.
文献信息
| PMID | 42844416 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Sophia P Schulze |
| 作者单位 | Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), LMU Medizin, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany. |
| 期刊 | Journal of neurology |
| SCI 分区 | Q1 |
| IF | 5.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景： 特定锻炼和生活方式相关建议被用于管理眩晕、头晕和平衡障碍（VDB），但关于老年人依从性及其决定因素的证据有限。本研究考察了治疗建议后3至12个月依从性的变化及其与疾病相关和患者相关因素的关联。
方法： 我们使用了MobilE-TRA 2前瞻性队列的数据，该队列纳入在德国一家三级转诊中心接受VDB治疗的年龄≥60岁成人。参与者在基线时接受评估，并在3个月和12个月后随访。自我报告的依从性使用五点Likert量表测量，并按预设截断值二分类。感知的眩晕相关障碍使用眩晕障碍量表（DHI）评估。纵向关联使用带随机截距的逻辑广义线性混合效应模型分析。
结果： 共纳入337名参与者（53%为女性；平均年龄71岁）。在调整分析中，特定锻炼的依从性在12个月时低于3个月时（比值比（OR）0.28；95%置信区间（CI）0.12-0.67）。较高的基线DHI评分与较高的特定锻炼依从性显著相关（OR 1.03；95% CI 1.00-1.06），但与生活方式相关建议无关（OR 1.00；95% CI 0.98-1.02）。男性性别与较低的生活方式相关建议依从性相关（OR 0.37；95% CI 0.16-0.88），而较高的自我效能与较高的依从性相关（OR 1.65；95% CI 1.02-2.66）。
结论： 在患有VDB的老年人中，依从性因建议类型、参与者特征和时间而异。这些发现可能为在初始随访之后支持VDB依从性的策略提供信息。
英文摘要
BACKGROUND: Specific exercises and lifestyle-related recommendations are used to manage vertigo, dizziness, and balance disorders (VDB), but evidence on adherence and its determinants in older adults is limited. This study examined adherence changes and associations with condition-related and patient-related factors from 3 to 12 months after therapeutic recommendations.
METHODS: We used data from the MobilE-TRA 2 prospective cohort of adults aged ≥60 years treated for VDB at a tertiary referral centre in Germany. The participants were assessed at baseline and followed up after 3 and 12 months. Self-reported adherence was measured using a five-point Likert scale and dichotomised at predefined cut-offs. Perceived dizziness-related handicap was assessed using the Dizziness Handicap Inventory (DHI). Longitudinal associations were analysed using logistic generalised linear mixed-effects models with random intercepts.
RESULTS: Overall, 337 participants were included (53% women; mean age 71 years). In adjusted analyses, adherence to specific exercises was lower at 12 than at 3 months (odds ratio (OR) 0.28; 95% confidence interval (CI) 0.12-0.67). Higher baseline DHI scores were significantly associated with higher adherence to specific exercises (OR 1.03; 95% CI 1.00-1.06), but not with lifestyle-related recommendations (OR 1.00; 95% CI 0.98-1.02). Male gender was associated with lower adherence to lifestyle-related recommendations (OR 0.37; 95% CI 0.16-0.88), while higher self-efficacy was associated with higher adherence (OR 1.65; 95%CI 1.02-2.66).
CONCLUSIONS: Adherence differed by recommendation type, participant characteristics and over time in older adults with VDB. These findings may inform strategies to support adherence in VDB beyond initial follow-up.