Department of Gerontology, Assistance Publique-Hôpitaux de Paris (Hôpital Broca), Paris, France.
Drugs Aging. 2010 Nov 1;27(11):895-901. doi: 10.2165/11584280-000000000-00000.
The multifactorial nature of falls is well known, and several studies on falls in the elderly have reported that laxatives can be a risk factor, but without attempting to discuss possible mechanisms to explain this role.
We aimed to isolate studies in which the risk factors for falls in the elderly related to laxatives have been evaluated and to carry out a meta-analysis combining the results of all identified good-quality studies.
Systematic literature review using the keywords 'accidental fall/numerical data' and 'risk factors'. This was followed by a manual search for articles cited in the previously identified publications. Articles were analysed if they had study populations aged ≥60 years, reported on falls occurring in everyday life, were observational or interventional studies that identified laxatives as a risk factor for falls, and were written in French or English. Articles of this type that were considered to be of good quality were included in the meta-analysis.
3747 indexed articles published between 1981 and 2007 were identified. Of these, seven articles met all inclusion criteria and were analysed. The odds ratio (95% CI) for the association between use of laxatives and fall occurrence in subjects participating in the good-quality trials (n = 4) included in the meta-analysis was 2.03 (1.52, 2.72). This result was statistically homogeneous (percentage of the total variation across studies due to heterogeneity [I2] = 0).
Elderly subjects treated with laxatives were twice as likely to fall compared with non-laxative users. The causal relationship was probably not directly attached to a side effect of the substance used, but rather a reflection of other pathologies (e.g. older age, confinement to bed, concomitant Parkinson's disease) that may themselves cause falls.
众所周知，跌倒的多因素性质，并且几项关于老年人跌倒的研究报告称，泻药可能是一个危险因素，但没有试图讨论可能的机制来解释这一作用。
我们旨在分离评估老年人跌倒与泻药相关的危险因素的研究，并对所有确定的高质量研究的结果进行荟萃分析。
使用关键词“意外跌倒/数值数据”和“危险因素”进行系统文献回顾。然后手动搜索之前确定的出版物中引用的文章。如果文章的研究人群年龄≥60 岁，报告日常生活中的跌倒，为观察性或干预性研究，确定泻药是跌倒的危险因素，并且用法语或英语书写，则对其进行分析。将被认为是高质量的此类文章纳入荟萃分析。
1981 年至 2007 年期间共检索到 3747 篇索引文章。其中，有 7 篇文章符合所有纳入标准并进行了分析。纳入荟萃分析的 4 项高质量试验（n=4）中，使用泻药与受试者跌倒发生之间的比值比（95%CI）为 2.03（1.52, 2.72）。该结果具有统计学一致性（由于异质性而导致研究之间总变异的百分比[I2]为 0）。
与非泻药使用者相比，接受泻药治疗的老年患者跌倒的可能性增加了一倍。这种因果关系可能不是直接与所使用物质的副作用有关，而是反映了其他可能导致跌倒的病理情况（例如，年龄较大，卧床不起，同时患有帕金森病）。
