Ziere G, Dieleman J P, Hofman A, Pols H A P, van der Cammen T J M, Stricker B H Ch
Section of Geriatric Medicine, Department of Internal Medicine, Erasmus MC, the Netherlands.
Br J Clin Pharmacol. 2006 Feb;61(2):218-23. doi: 10.1111/j.1365-2125.2005.02543.x.
Falls in the elderly are common and often serious. We studied the association between multiple drug use (polypharmacy) and falls in the elderly.
This was a population-based cross-sectional study, part of the Rotterdam Study. The participants were 6928 individuals aged > or = 55 years. The prevalence of falls in the previous year was assessed. Medication use was determined with an interviewer-administered questionnaire with verification of use. Polypharmacy was defined as the use of four or more drugs per day.
The prevalence of falls strongly increased with age. Falls were more common in women than in men. Fall risk increased with increasing disability, presence of joint complaints, use of a walking aid and fracture history. The risk of falling increased significantly with the number of drugs used per day (P for trend < 0.0001). After adjustment for a large number of comorbid conditions and disability, polypharmacy remained a significant risk factor for falling. Stratification for polypharmacy with or without at least one drug which is known to increase fall risk (notably CNS drugs and diuretics) disclosed that only polypharmacy with at least one risk drug was associated with an increased risk of falling.
Fall risk is associated with the use of polypharmacy, but only when at least one established fall risk-increasing drug was part of the daily regimen.
老年人跌倒很常见且往往后果严重。我们研究了多重用药（多药合用）与老年人跌倒之间的关联。
这是一项基于人群的横断面研究，是鹿特丹研究的一部分。参与者为6928名年龄≥55岁的个体。评估了前一年跌倒的患病率。通过访员管理的问卷确定用药情况，并核实用药情况。多药合用定义为每天使用四种或更多种药物。
跌倒的患病率随年龄大幅增加。女性跌倒比男性更常见。跌倒风险随着残疾程度增加、有关节疼痛、使用助行器和有骨折史而增加。每天使用的药物数量增加，跌倒风险显著增加（趋势P<0.0001）。在对大量共病情况和残疾进行调整后，多药合用仍然是跌倒的一个重要危险因素。对多药合用进行分层，分为有或没有至少一种已知会增加跌倒风险的药物（特别是中枢神经系统药物和利尿剂），结果显示只有使用至少一种风险药物的多药合用与跌倒风险增加有关。
跌倒风险与多药合用有关，但只有当至少一种已确定的增加跌倒风险的药物是日常用药方案的一部分时才有关。
