基于人口的干预措施,以预防老年人跌倒和跌倒相关的伤害
Sharon R Lewis1, Lisa McGarrigle2, Michael W Pritchard1
1Bone and Joint Health, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
The Cochrane database of systematic reviews
|January 5, 2024
概括
关于预防老年人跌倒的全社区干预措施的证据尚不确定. 需要更强大的研究来确定这些基于人口的防摔策略的有效性.
科学领域:
- 老年学与公共卫生
- 老龄化的流行病学.
- 伤害预防 研究 研究 研究 预防伤害
背景情况:
- 大约三分之一的社区老年人每年都会摔倒.
- 针对整个社区跌的决定因素的人口层面干预措施提供了一种可扩展的预防方法.
- 这些干预措施包括政策变化,环境修改和促进体育活动的公共卫生计划.
研究的目的:
- 系统地审查和综合有关预防老年人跌倒和相关伤害的基于人口的干预措施有效性的证据.
- 评估旨在修改摔倒的社会,文化和环境风险因素的全社区倡议.
主要方法:
- 搜索了多个数据库 (CENTRAL,MEDLINE,Embase) 和试验注册到2023年1月.
- 包括随机对照试验 (RCT),集群RCT,阶梯设计和受控非随机研究.
- 专注于针对整个社区的干预措施,不包括对高风险个人或机构机构的干预措施.
主要成果:
- 包括9项研究 (2个集群RCT,7个非随机试验),评估多组分干预措施.
- 药物/营养干预 (和维生素D) 和多组分干预 (运动,环境修改,教育) 的有效性证据的确定性非常低.
- 没有研究报告了不良事件;关于跌倒率,受伤率和住院病人的发现是不一致的或不确定的,这是由于研究的局限性和证据的低确定性.
结论:
- 目前的证据不足以确定基于人口的多组分或营养/药物干预措施的有效性,以防止老年人跌.
- 需要在方法上强大的集群RCT,具有大规模的社区参与和详细的干预描述.
- 建议在未来的研究中使用像ProFaNE这样的分类学来进行标准化报告,以提高一致性和可比性.
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