Heathcare for Older People, Nottingham University Hospital NHS Trust, Nottingham, UK.
Age Ageing. 2013 Jan;42(1):121-4. doi: 10.1093/ageing/afs118. Epub 2012 Aug 29.
drugs acting on the central nervous system (CNS) increase falls risk. Most data on CNS drugs and falls are in women/mixed-sex populations. This study assessed the relationship between CNS drugs and falls in men aged 60-75 years.
a questionnaire was sent to randomly selected Danish men aged 60-75 years. Cross-sectional data on CNS drugs and falls in the previous year were available for 4,696 men. Logistic regression investigated the relationship between falls and CNS drugs.
the median age was 66.3 (IQR = 63.1-70.0) years; 21.7% were fallers. The following were associated with fallers (OR; 95% CI): opiates (2.4; 1.5-3.7), other analgesics (1.7; 1.4-2.1), antiepileptics (2.8; 1.5-5.1), antidepressants (2.8; 1.9-4.1) and anxiolytics/hypnotics (1.5; 0.9-2.6). Effects of opiates interacted strongly and significantly with age, with a marked association with falls in the older half of the subjects only. No significant associations were found between antipsychotics and fallers. Selective serotonin reuptake inhibitors and tricyclics were significantly associated with fallers (3.1; 2.0-5.0 and 2.2; 1.0-4.7, respectively).
several CNS drug classes are associated with an approximately 2-3-fold increase risk of falls in men aged 60-75 years randomly selected from the population. Further longitudinal data are now required to confirm and further investigate the role of CNS drugs in falls causation in men.
作用于中枢神经系统(CNS)的药物会增加跌倒风险。大多数关于 CNS 药物和跌倒的研究数据都来自女性/混合性别人群。本研究评估了 60-75 岁男性中 CNS 药物与跌倒之间的关系。
向随机抽取的丹麦 60-75 岁男性发送问卷。4696 名男性提供了上一年 CNS 药物和跌倒的横断面数据。Logistic 回归分析了跌倒与 CNS 药物之间的关系。
中位年龄为 66.3(IQR=63.1-70.0)岁;21.7%为跌倒者。以下因素与跌倒者相关(OR;95%CI):阿片类药物(2.4;1.5-3.7)、其他止痛药(1.7;1.4-2.1)、抗癫痫药(2.8;1.5-5.1)、抗抑郁药(2.8;1.9-4.1)和抗焦虑药/催眠药(1.5;0.9-2.6)。阿片类药物的作用与年龄之间存在强烈的相互作用且具有显著意义,仅与研究对象的较老年组有明显关联。抗精神病药与跌倒者之间无显著相关性。选择性 5-羟色胺再摄取抑制剂和三环类抗抑郁药与跌倒者显著相关(3.1;2.0-5.0 和 2.2;1.0-4.7)。
从人群中随机抽取的 60-75 岁男性中,几种 CNS 药物类别与跌倒风险增加约 2-3 倍相关。目前需要进一步的纵向数据来证实和进一步研究 CNS 药物在男性跌倒病因中的作用。