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药物及多种药物治疗对社区中反复跌倒者的影响:一项系统综述

Medications & Polypharmacy Influence on Recurrent Fallers in Community: a Systematic Review.

作者信息

Ming Yu, Zecevic Aleksandra

机构信息

Graduate Program, Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada.

School of Health Studies, Faculty of Health Sciences, Western University, London, ON, Canada.

出版信息

Can Geriatr J. 2018 Mar 26;21(1):14-25. doi: 10.5770/cgj.21.268. eCollection 2018 Mar.

Abstract

The purpose of this systematic review is to summarize information about the impact different classes of medications and polypharmacy have on recurrent falls, defined as two or more falls in a 12-month period, in community-dwelling older adults. After adjustment for confounders such as age, gender, weight or depression symptoms, the reviewed studies suggested that older adults who use antidepressants, sedatives or hypnotics and anti-epileptics were more likely to experience recurrent falls than non-users. Polypharmacy (use of four or more prescription medications daily) caused 1.5-2 times higher possibility of recurrent falls in older adults. As a high-risk group, recurrent fallers require meaningful intervention. Medications are believed to be a modifiable risk factor in falls prevention; hence, special consideration should be taken to balance the benefit and harm in initiating, continuing or increasing certain classes of medications in elderly recurrent fallers.

摘要

本系统评价的目的是总结不同类别药物及多种药物联合使用对社区居住的老年人反复跌倒(定义为在12个月内发生两次或更多次跌倒)的影响。在对年龄、性别、体重或抑郁症状等混杂因素进行调整后,所审查的研究表明,使用抗抑郁药、镇静剂或催眠药以及抗癫痫药的老年人比未使用者更有可能反复跌倒。多种药物联合使用(每天使用四种或更多处方药)使老年人反复跌倒的可能性增加1.5至2倍。作为一个高危群体,反复跌倒者需要有意义的干预。药物被认为是预防跌倒中一个可改变的风险因素;因此,在老年反复跌倒者中开始、继续或增加某些类别的药物时,应特别考虑权衡利弊。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d44/5864570/16957b29c856/cgj-21-14f1.jpg

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