Department of Research, Development and Education, St. Maartenskliniek, Nijmegen, The Netherlands.
Hum Mov Sci. 2011 Apr;30(2):384-95. doi: 10.1016/j.humov.2010.05.011. Epub 2010 Aug 12.
Accidental falls in older individuals are a major health and research topic. Increased reaction time and impaired postural balance have been determined as reliable predictors for those at risk of falling and are important functions of the central nervous system (CNS). An essential risk factor for falls is medication exposure. Amongst the medications related to accidental falls are the non-steroidal anti-inflammatory drugs (NSAIDs). About 1-10% of all users experience CNS side effects. These side effects, such as dizziness, headaches, drowsiness, mood alteration, and confusion, seem to be more common during treatment with indomethacin. Hence, it is possible that maintenance of (static) postural balance and swift reactions to stimuli are affected by exposure to NSAIDs, indomethacin in particular, consequently putting older individuals at a greater risk for accidental falls. The present study investigated the effect of a high indomethacin dose in healthy middle-aged individuals on two important predictors of falls: postural balance and reaction time. Twenty-two healthy middle-aged individuals (59.5 ± 4.7 years) participated in this double-blind, placebo-controlled, randomized crossover trial. Three measurements were conducted with a week interval each. A measurement consisted of postural balance as a single task and while concurrently performing a secondary cognitive task and reaction time tasks. For the first measurement indomethacin 75 mg (slow-release) or a visually identical placebo was randomly assigned. In total, five capsules were taken orally in the 2.5 days preceding assessment. The second measurement was without intervention, for the final one the first placebo group got indomethacin and vice versa. Repeated measures GLM revealed no significant differences between indomethacin, placebo, and baseline in any of the balance tasks. No differences in postural balance were found between the single and dual task conditions, or on the performance of the dual task itself. Similarly, no differences were found on the manual reaction time tasks. The present study showed that a high indomethacin dose does not negatively affect postural balance and manual reaction time in this healthy middle-aged population. Although the relatively small and young sample limits the direct ability to generalize the results to a population at risk of falling, the results indicate that indomethacin alone is not likely to increase fall risk, as far as this risk is related to above mentioned important functions of the CNS, and not affected by comorbidities.
老年人意外跌倒属于一个重要的健康和研究课题。反应时间延长和姿势平衡受损已被确定为有跌倒风险的可靠预测指标,而这些指标是中枢神经系统(CNS)的重要功能。药物暴露是跌倒的一个重要危险因素。与意外跌倒相关的药物之一是非甾体抗炎药(NSAIDs)。约有 1-10%的使用者会出现 CNS 副作用。这些副作用,如头晕、头痛、嗜睡、情绪改变和意识混乱,在使用吲哚美辛时似乎更为常见。因此,CNS 可能会受到 NSAIDs 暴露的影响,特别是吲哚美辛,这会影响老年人的姿势平衡和对刺激的快速反应,从而使他们更容易发生意外跌倒。本研究调查了高剂量吲哚美辛对健康中年个体两个重要跌倒预测指标的影响:姿势平衡和反应时间。22 名健康中年个体(59.5±4.7 岁)参与了这项双盲、安慰剂对照、随机交叉试验。每项测量之间间隔一周进行三次。测量包括姿势平衡作为一项单一任务,以及同时进行次要认知任务和反应时间任务。第一次测量中,随机分配吲哚美辛 75mg(缓释)或外观相同的安慰剂。总共在 2.5 天内口服 5 粒胶囊进行评估。第二次测量无干预,第三次测量时,第一组安慰剂个体服用吲哚美辛,反之亦然。重复测量 GLM 显示,在任何平衡任务中,吲哚美辛、安慰剂和基线之间均无显著差异。在单一任务和双重任务条件下,或在双重任务本身的表现上,均未发现姿势平衡有差异。手动反应时间任务也没有差异。本研究表明,在健康中年人群中,高剂量吲哚美辛不会对姿势平衡和手动反应时间产生负面影响。尽管相对较小的年轻样本限制了将结果直接推广到有跌倒风险的人群的能力,但结果表明,只要跌倒风险与上述 CNS 重要功能有关,并且不受合并症的影响,吲哚美辛单独使用不太可能增加跌倒风险。