高齢者の転倒防止のための介入:米国の予防サービスタスクフォースのための最新の証拠報告と体系的なレビュー
Janelle M Guirguis-Blake1,2, Yvonne L Michael3, Leslie A Perdue1
1Kaiser Permanente Research Affiliates Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon.
JAMA
|May 1, 2018
まとめ
運動と多要素介入により 高齢者の転倒を効果的に減らすことができます 運動による介入は様々な転倒に関連する結果において 最も一貫した効果を示したが,ビタミンDの補給は 異なった結果を示した.
科学分野:
- ゲロントロジー
- 予防医学
- 公衆衛生
背景:
- 落下は高齢者の怪我や 病気や死亡の主な原因です
- 効果的な落下防止戦略は高齢者の健康と自立を維持するために不可欠です
研究 の 目的:
- 地域社会に住む高齢者の転倒防止の効果と害を体系的に検討する.
- 落下防止のための証拠に基づいたガイドラインを提示する.
主な方法:
- 2016年8月まで発表されたランダム化臨床試験 (RCT) の系統的レビューで,2018年2月まで継続的な監視が行われました.
- 対象となった研究は,65歳以上のコミュニティに住む成人を対象としたものです.
- データを批判的に評価し,ランダム効果モデルを使用してメタ解析を行った2人の独立したレビュー者によって抽象化されました.
主要な成果:
- マルチファクター,運動,ビタミンDの介入に焦点を当てた62件のRCTを分析した.
- 多因子介入は,転落の発生率 (IRR,0. 79) を減少させたが,他のアウトカムには影響しなかった.
- 運動による介入は,転倒 (RR,0.89) と怪我による転倒 (IRR,0.81) を有意に減少させた.
- ビタミンDのサプリメントは混合的な結果を示し,高用量は潜在的に転倒率を増加させた.
結論:
- マルチファクタリー介入と運動介入の両方が,転倒予防に有益であることが示されています.
- 運動による介入は,複数の落下に関連する結果において,最も一貫した有効性の証拠を提供しました.
- 落下防止におけるビタミンDサプリメントの役割は不明であり,特に最適な用量に関するさらなる調査が必要である.
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