伤害性跌倒风险差异在老年人中与第一线抑郁症治疗
Grace Hsin-Min Wang1, Edward Chia-Cheng Lai2, Amie J Goodin1
1Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville.
JAMA network open
|August 26, 2024
概括
除了心理治疗之外,第一线抗抑郁药与抑郁症的老年人中跌倒和相关伤害的风险较低有关. 这表明这些常见的治疗方法的概况可能比以前认为的更安全.
科学领域:
- 老年学是一门学科.
- 精神病学是一个精神病学.
- 流行病学 流行病学
背景情况:
- 抑郁症影响美国三分之一的老年人,通常用心理治疗和抗抑郁药物治疗.
- 关于抗抑郁药物相关的跌倒和受伤的先前研究可能会受到混因素的偏见.
- 跌倒和相关伤害 (FRI) 对老年人口构成重大健康风险.
研究的目的:
- 调查一线抑郁症治疗与老年人中跌倒和相关伤害 (FRI) 的风险之间的关联.
- 为老年抑郁症管理中抗抑郁药物的安全性提供基于证据的见解.
主要方法:
- 一项使用目标试验仿真框架的队列研究,对医疗保险索赔数据 (2016-2019) 进行克隆-审查-加权.
- 包括65岁及以上的收费服务受益者,新诊断患有抑郁症.
- 分析一年的FRI率,受限制的平均存活时间 (RMST) 和调整的危险比率 (aHR).
主要成果:
- 在101,953名参与者中,心理治疗与FRI风险无关 (aHR,0.94).
- 除了心理治疗之外,第一线抗抑郁药与未接受治疗的个人相比,显示FRI风险降低 (aHR范围:0.74对布洛普里昂到0.83对埃斯基塔洛普拉姆).
- 用布洛治疗的FRI发病率较低 (63/1000人/年),而不是未接受治疗的个体 (87/1000人/年).
结论:
- 当用于老年人的抑郁症时,一线抗抑郁药与降低跌倒和相关伤害的风险有关.
- 这些发现挑战了以前的担忧,并突出了这些药物在这个人口群体中潜在的有利安全概况.
- 该研究有助于临床医生在考虑疗效和安全结果时,就老年人抑郁症治疗做出明智的决定.
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