Laboratory of Drug Lifetime Management, Graduate School of Pharmaceutical Sciences, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Sompo Care Inc., 4-12-8 Higashi-shinagawa, Shinagawa-ku, Tokyo, 140-0002, Japan.
Aging Clin Exp Res. 2020 May;32(5):885-892. doi: 10.1007/s40520-019-01265-9. Epub 2019 Jul 17.
Falls are a significant problem for older people, but are few studies of the risk of falling in residents of nursing homes in Japan. We aimed to investigate the risk factors for falls and the association of medication use and falls in nursing home residents in Japan.
This case-control study reviewed the records of residents of who were ≥ 65 years of age and had fallen in 2012 and an age-, sex-, and facility-matched control group selected from 58 nursing homes in Japan. The odds ratios of potential risk factors and current medications were determined by conditional logistic regression.
A total of 1832 residents (916 cases and 916 controls) were included. Falls were significantly associated with an inability to walk without assistance or stand up without assistance, need for toileting assistance, visual impairment, insomnia, and dementia. Current prescription of antithrombotic, nonsteroidal anti-inflammatory, or antiparkinson drugs, muscle relaxants, antiepileptics, antipsychotics, antidepressants, opioids, selective serotonin reuptake inhibitors, and memantine was also associated with increased risk of falling.
Many medications were associated with falls in nursing homes residents in Japan. To prevent these falls, caregivers should provide adequate care, and healthcare professionals should consider switching or dose reduction for these medications.
跌倒对老年人来说是一个严重的问题，但日本养老院居民跌倒风险的研究较少。我们旨在调查日本养老院居民跌倒的危险因素以及与药物使用的关系。
这项病例对照研究回顾了 2012 年跌倒的≥65 岁居民的记录，并从日本 58 家养老院中选择了年龄、性别和设施相匹配的对照组。通过条件逻辑回归确定潜在危险因素和当前用药的比值比。
共纳入 1832 名居民（916 例病例和 916 例对照）。无法在没有帮助的情况下行走或站立、需要协助如厕、视力障碍、失眠和痴呆与跌倒显著相关。目前使用抗血栓、非甾体抗炎药或抗帕金森病药物、肌肉松弛剂、抗癫痫药、抗精神病药、抗抑郁药、阿片类药物、选择性 5-羟色胺再摄取抑制剂和盐酸美金刚也与跌倒风险增加相关。
许多药物与日本养老院居民的跌倒有关。为了预防这些跌倒，护理人员应提供充分的护理，医护人员应考虑更换或减少这些药物的剂量。
