在安大略省的老年人中增加跌倒风险的药物和跌倒相关的伤害:基于人口的匹配病例控制研究
Mahin Delara1, Krista M Reich2, Wai-Yip Chan3
1Department of Psychiatry, Queen's University, Kingston, Ontario, Canada; Vaccine Evaluation Centre, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, British Columbia, Canada; Department of Obstetrics and Gynaecology, Royal Columbia Hospital, Fraser Health Authority, New Westminster, British Columbia, Canada.
Journal of the American Medical Directors Association
|March 27, 2025
概括
使用多种降落风险增加药物 (FRIDs) 显著提高了老年人与跌倒有关的伤害的风险. 降低高风险的FRID对于有效的防摔策略至关重要.
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:
- 众所周知,通常处方的药物会单独增加跌倒的风险.
- 使用多种降落风险增加药物 (FRIDs) 对跌倒相关伤害的影响不太清楚.
- 在家庭护理 (HC) 和长期护理 (LTC) 环境中的老年人特别脆弱.
研究的目的:
- 为了检查12个主要的FRID类别之间的联系,单独和组合使用,以及与跌倒相关的伤害.
- 为了比较与FRID使用相关的跌倒相关伤害的风险,在HC与LTC人群中.
- 为了确定具有最高相关风险的特定FRID类.
主要方法:
- 采用了一种匹配的病例控制研究设计.
- 从2008年至2016年期间,从加拿大安大略省的HC接收者和LTC居民收集了数据.
- 多变量逻辑回归分析了在跌倒前90天内FRID暴露,并与性别,年龄,跌倒史,日历年和疾病风险得分相匹配.
主要成果:
- 与非使用者相比,任何FRID使用都会增加HC (aOR, 1.34) 和LTC (aOR, 1.54) 群体中与跌倒相关的受伤风险.
- 多巴胺类药物和抗抑郁药显示,跌倒相关伤害的几率最高.
- 暴露在五个或更多的FRID中,在HC (aOR,1.67) 和LTC (aOR,1.92) 设置中,与跌倒有关的伤害的几率几乎翻了一番.
结论:
- 多种类型的FRID与老年人落相关伤害风险的增加有显著的关联.
- 临床医生应优先考虑尽可能减少这些药物的使用.
- 预防跌倒的计划必须整合高风险FRID的抑郁症的策略.
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