预防老年人跌倒的干预措施:美国预防服务工作组的最新证据报告和系统审查
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
概括
运动和多因素干预有效地减少老年人的跌倒. 运动干预在各种与跌倒相关的结果中显示出最一致的益处,而维生素D补充则产生了混合的结果.
科学领域:
- 老年学
- 预防医学
- 公共卫生
背景情况:
- 跌倒是老年人受伤,发病和死亡的主要原因.
- 有效的防摔策略对于保持老龄人口的健康和独立至关重要.
研究的目的:
- 系统地审查社区老年人的防摔干预措施的有效性和危害.
- 提供基于证据的指导方针,
主要方法:
- 在2016年8月发布的随机临床试验 (RCT) 的系统审查,并持续监测到2018年2月.
- 包括的研究集中在65岁及以上的社区成年人身上.
- 两位独立审稿人对数据进行了批判性评估和抽象,并使用随机效应模型进行了元分析.
主要成果:
- 分析了62个RCT,重点是多因素,运动和维生素D干预.
- 多因素干预降低了跌倒发生率 (IRR,0.79),但没有其他结果.
- 运动干预显著减少了遇到跌倒的人数 (RR,0.89) 和受伤跌倒的人数 (IRR,0.81).
- 维生素D的补充显示出不同的结果,高剂量可能会增加跌倒率.
结论:
- 多因素干预和运动干预都在预防跌倒方面显示出好处.
- 运动干预提供了最一致的证据,证明了与跌倒相关的多种结果的有效性.
- 维生素D补充剂在预防跌倒方面的作用尚不确定,需要进一步研究,特别是在最佳剂量方面.
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