Lawlor Debbie A, Patel Rita, Ebrahim Shah
Department of Social Medicine, University of Bristol, Bristol BS8 2PR.
BMJ. 2003 Sep 27;327(7417):712-7. doi: 10.1136/bmj.327.7417.712.
To assess the associations between having had a fall and chronic diseases and drug use in elderly women.
Cross sectional survey, using data from the British women's heart and health study.
General practices in 23 towns in Great Britain.
4050 women aged 60-79 years.
Whether women had had falls in the previous 12 months.
The prevalence of falling increased with increasing numbers of simultaneously occurring chronic diseases. However, no such relation with falling was found in the fully adjusted data for the number of drugs used. Circulatory disease, chronic obstructive pulmonary disease, depression, and arthritis were all associated with an increased odds of falling. The fully adjusted, population attributable risk of falling associated with having at least one chronic disease was 32.2% (95% confidence interval 19.6% to 42.8%). Only two classes of drugs (hypnotics and anxiolytics, and antidepressants) were independently associated with an increased odds of falling. Each class was associated with an increase of about 50% in the odds of falling, and each had a population attributable risk of < 5%.
Chronic diseases and multiple pathology are more important predictors of falling than polypharmacy.
评估老年女性跌倒与慢性病及药物使用之间的关联。
横断面调查,使用英国女性心脏与健康研究的数据。
英国23个城镇的全科医疗诊所。
4050名年龄在60 - 79岁的女性。
女性在过去12个月内是否跌倒。
跌倒的患病率随着同时发生的慢性病数量增加而上升。然而,在对用药数量进行完全调整的数据中未发现与跌倒有此类关联。循环系统疾病、慢性阻塞性肺疾病、抑郁症和关节炎均与跌倒几率增加相关。至少有一种慢性病与跌倒相关的完全调整后的人群归因风险为32.2%(95%置信区间为19.6%至42.8%)。只有两类药物(催眠药和抗焦虑药以及抗抑郁药)与跌倒几率增加独立相关。每类药物与跌倒几率增加约50%相关,且每类药物的人群归因风险均<5%。
慢性病和多种病理状况比多重用药更能预测跌倒。