单次和联合使用增加跌倒风险的药物和骨折风险:基于人口的病例控制研究
Jonathan Hauff1, Marietta Rottenkolber1, Patrick Oehler1
1Institute of General Practice and Family Medicine, University Hospital of Ludwig-Maximilians-University Munich, Munich 80336, Germany.
老年人,特别是75岁以上的老年人,面临着由降落风险增加药物 (FRID) 引起的骨折风险更高. 降低这些药物的处方,如抗抑郁药和抗精神病药,可以显著减少危害.
科学领域:
- 老年学是一门学科.
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 跌倒是老年人主要关注的问题,吸毒是其中一个重要因素.
- 虽然许多药物类别与跌倒有关,但药物类型和患者群体之间的确切风险增加和变化仍然不清楚.
研究的目的:
- 在65岁及以上的个人中调查降落风险增加药物 (FRID) 的相对和绝对风险.
- 为了检查这些风险在年轻 (65-74岁) 和老年 (≥75岁) 成年人之间有何差异.
- 评估结合多个FRID对骨折风险的影响.
主要方法:
- 一项基于人口的嵌套病例控制研究在苏格兰泰赛德和菲夫 (2010-2020年) 进行.
- 病例是因骨折 (≥65岁) 住院的个人;每例最多匹配10个对照.
- 条件后勤回归被用来分析FRID暴露 (单独或组合) 和骨折结果之间的关联,调整混因子.
主要成果:
- 大多数研究的FRID与老年人骨折风险显著增加有关.
- 与年轻人相比,老年人 (≥75岁) 的绝对骨折风险明显高于年轻人.
- 骨折风险绝对增加的最高值在那些使用选择性血清素再吸收抑制剂 (伤害所需的数量[NNH]53),三环抗抑郁药物 (NNH81),抗精神病药物 (NNH75) 或≥3个FRID (NNH ≤66) 的≥75岁的人群中观察到.
结论:
- 老年人 (≥75岁) 处方抗抑郁药,抗精神病药或多种增加跌倒风险的药物 (FRID) 的骨折风险最高.
- 针对这些特定药物类别和患者群体的减缓干预措施可能在预防骨折方面产生最大的益处.
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