Du Yong, Wolf Ingrid-Katharina, Knopf Hildtraud
Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin Germany.
PLoS One. 2017 Aug 8;12(8):e0182432. doi: 10.1371/journal.pone.0182432. eCollection 2017.
To investigate the association of psychotropic drug use with falls among older adults in Germany based on data from the National Health Interview and Examination Survey for Adults 2008-2011 (DEGS1).
DEGS1 collected data on drug use in the past 7 days and on falls occurred in the last 12 months. Study participants were older adults aged 65-79 years with complete data on drug use and falls (N = 1,833). Odds ratio (OR) and 95% confidence intervals (95% CI) were derived from logistic regression models adjusting for potential confounders including socio-demographic characteristics, health-related behaviors (alcohol drinking), body mass index and health conditions (frailty, vision impairment, disability, polypharmacy, blood pressure) as well as use of potential falls-risk-increasing drugs. SPSS complex sample methods were used for statistical analysis.
Compared to people without falls, people with falls (n = 370) had a higher psychotropic drug use (33.1% vs. 20.7%, p < .001). After adjusting for potential confounders, use of psychotropic drugs overall was associated with a higher risk of falls (OR 1.64, 95% CI 1.14-2.37). This was particularly true for the use of synthetic psychotropic drugs (1.57, 1.08-2.28), antidepressants overall (2.88, 1.63-5.09) or synthetic antidepressants (2.66, 1.50-4.73), specifically, selective serotonin reuptake inhibitors (SSRIs) (6.22, 2.28-17.0). Similar results were found for recurrent falls.
Use of psychotropic drugs overall, especially synthetic antidepressants like SSRIs, is associated with higher risks of falls and recurrent falls among community dwelling older adults aged 65-79 years in Germany.
基于2008 - 2011年成人国民健康访谈与检查调查(DEGS1)的数据,调查德国老年人使用精神药物与跌倒之间的关联。
DEGS1收集了过去7天的药物使用数据以及过去12个月内发生的跌倒数据。研究参与者为年龄在65 - 79岁之间、有完整药物使用和跌倒数据的老年人(N = 1833)。比值比(OR)和95%置信区间(95%CI)来自逻辑回归模型,该模型对潜在混杂因素进行了调整,包括社会人口学特征、健康相关行为(饮酒)、体重指数和健康状况(虚弱、视力障碍、残疾、多重用药、血压)以及使用可能增加跌倒风险的药物。采用SPSS复杂样本方法进行统计分析。
与未跌倒的人相比,跌倒者(n = 370)使用精神药物的比例更高(33.1%对20.7%,p <.001)。在对潜在混杂因素进行调整后,总体精神药物使用与更高的跌倒风险相关(OR 1.64,95%CI 1.14 - 2.37)。合成精神药物的使用尤其如此(1.57,1.08 - 2.28),总体抗抑郁药(2.88,1.63 - 5.09)或合成抗抑郁药(2.66,1.50 - 4.73),具体而言,选择性5-羟色胺再摄取抑制剂(SSRIs)(6.22,2.28 - 17.0)。复发性跌倒也发现了类似结果。
在德国,65 - 79岁的社区居住老年人中,总体精神药物使用,尤其是像SSRIs这样的合成抗抑郁药,与跌倒和复发性跌倒的更高风险相关。