School of Pharmacy, Royal College of Surgeons in Ireland (RCSI), Dublin 2, Ireland.
HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland.
Age Ageing. 2019 Nov 1;48(6):824-831. doi: 10.1093/ageing/afz112.
To investigate the association between potentially serious alcohol-medication interactions (POSAMINO criteria), hypothesised to increase the risk of falls in older adults, and falls in community-dwelling older adults at two and 4 years follow-up.
A prospective cohort study.
The Irish Longitudinal Study on Ageing.
A total of 1,457 community-dwelling older adults aged ≥65 years, with a complete alcohol and regular medication data to allow for the application of the POSAMINO criteria.
Self-reported falls at 2 and 4 years follow-up, any falls (yes/no), injurious falls (yes/no) and number of falls (count variable).
The number of participants who reported falling since their baseline interview at 2 and 4 years were 357 (24%) and 608 (41.8%), respectively; 145 (10%) reported an injurious fall at 2 years and 268 (18%) at 4 years. Median (IQR) number of falls was 1 (1-2) at 2 years and 2 (1-3) at 4 years. Exposure to CNS POSAMINO criteria, hypothesised to increase the risk of falls due primarily to increased sedation, was associated with a significantly increased risk for falling (adjusted relative risk (RR) 1.50, 95% confidence interval (CI) 1.21-1.88) and for injurious falls (adjusted RR 1.62, 95% CI: 1.03-2.55) at 4 years. These equate to an absolute risk of 19% for falling (95% CI: 5-33%) and 8% for injurious falls (95% CI, 4-20%) at 4 years.
Assessment and management strategies to prevent falls in community-dwelling older adults should consider patients' alcohol consumption alongside their assessment of patient medications, particularly among those receiving CNS agents.
调查潜在严重的酒精-药物相互作用（POSAMINO 标准）与社区老年人跌倒之间的关联，这些相互作用被假设会增加老年人跌倒的风险，并在两年和四年随访中与跌倒相关。
前瞻性队列研究。
爱尔兰老龄化纵向研究。
共有 1457 名年龄在 65 岁及以上、有完整酒精和常规药物数据的社区居住的老年人，这些数据允许应用 POSAMINO 标准。
在 2 年和 4 年的随访中，自我报告跌倒的人数分别为 357（24%）和 608（41.8%）；145（10%）人在 2 年时报告了受伤性跌倒，268（18%）人在 4 年时报告了受伤性跌倒。2 年时的跌倒中位数（IQR）为 1（1-2），4 年时为 2（1-3）。CNS POSAMINO 标准（假设主要因镇静作用增加而增加跌倒风险）的暴露与跌倒（校正后的相对风险（RR）1.50，95%置信区间（CI）1.21-1.88）和受伤性跌倒（校正后的 RR 1.62，95%CI：1.03-2.55）的风险显著增加有关。这相当于 4 年内跌倒的绝对风险增加 19%（95%CI：5-33%）和受伤性跌倒的绝对风险增加 8%（95%CI，4-20%）。
评估和管理社区老年人跌倒的策略应考虑患者的饮酒情况，以及对患者药物的评估，尤其是那些接受 CNS 药物的患者。
