Department of Geriatric Medicine, University Medical Center, Utrecht, The Netherlands.
Maturitas. 2013 Apr;74(4):357-62. doi: 10.1016/j.maturitas.2013.01.004. Epub 2013 Jan 31.
Falls in the elderly are common and often serious. The aim of this study was to examine the association between the use of different classes of psychotropic medications, especially short acting benzodiazepines, and the frequency of falling in elderly. Study design This retrospective cohort study was performed with patients who visited the day clinic of the department of geriatric medicine of the University Medical Center Utrecht in the Netherlands between 1 January 2011 and 1 April 2012. Measurements Frequencies of falling in the past year and medication use were recorded. Logistic regression analysis was performed to assess the relationship between the frequency of falling in the past year and the use of psychotropic medications.
During this period 404 patients were included and 238 (58.9%) of them had experienced one or more falls in the past year. After multivariate adjustment, frequent falls remained significantly associated with exposure to psychotropic medications (odds ratio [OR] 1.96; 95% confidence interval [CI] 1.17-3.28), antipsychotics (OR 3.62; 95% CI 1.27-10.33), hypnotics and anxiolytics (OR 1.81; 95% CI 1.05-3.11), short-acting benzodiazepines or Z-drugs (OR 1.94; 95% CI 1.10-3.42) and antidepressants (OR 2.35; 95% CI 1.33-4.16).
This study confirms that taking psychotropic medication, including short-acting benzodiazepines, strongly increases the frequency of falls in elderly. This relation should be explicitly recognized by doctors prescribing for older people, and by older people themselves. If possible such medication should be avoided for elderly patients especially with other risk factors for falling.
老年人跌倒很常见,且往往较为严重。本研究旨在探讨使用不同类别的精神药物(尤其是短效苯二氮䓬类药物)与老年人跌倒频率之间的关系。
本回顾性队列研究纳入了 2011 年 1 月 1 日至 2012 年 4 月 1 日期间在荷兰乌得勒支大学医学中心老年医学科日间门诊就诊的患者。
记录过去一年的跌倒频率和药物使用情况。采用逻辑回归分析评估过去一年的跌倒频率与精神药物使用之间的关系。
在此期间共纳入 404 例患者,其中 238 例(58.9%)在过去一年中有过一次或多次跌倒。经多变量调整后,频繁跌倒仍与使用精神药物显著相关(比值比 [OR] 1.96;95%置信区间 [CI] 1.17-3.28)、抗精神病药物(OR 3.62;95% CI 1.27-10.33)、催眠药和抗焦虑药(OR 1.81;95% CI 1.05-3.11)、短效苯二氮䓬类药物或 Z 类药物(OR 1.94;95% CI 1.10-3.42)和抗抑郁药(OR 2.35;95% CI 1.33-4.16)。
本研究证实,服用精神药物,包括短效苯二氮䓬类药物,会显著增加老年人跌倒的频率。这一关系应引起开处方给老年人的医生和老年人自身的明确认识。如有可能,应避免此类药物用于有其他跌倒风险因素的老年患者。