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老年人跌倒预防和管理的新视野:一项全球倡议。

New horizons in falls prevention and management for older adults: a global initiative.

机构信息

Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, ON, Canada.

Division of Geriatric Medicine, Department of Medicine, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada.

出版信息

Age Ageing. 2021 Sep 11;50(5):1499-1507. doi: 10.1093/ageing/afab076.

Abstract

BACKGROUND

falls and fall-related injuries are common in older adults, have negative effects both on quality of life and functional independence and are associated with increased morbidity, mortality and health care costs. Current clinical approaches and advice from falls guidelines vary substantially between countries and settings, warranting a standardised approach. At the first World Congress on Falls and Postural Instability in Kuala Lumpur, Malaysia, in December 2019, a worldwide task force of experts in falls in older adults, committed to achieving a global consensus on updating clinical practice guidelines for falls prevention and management by incorporating current and emerging evidence in falls research. Moreover, the importance of taking a person-centred approach and including perspectives from patients, caregivers and other stakeholders was recognised as important components of this endeavour. Finally, the need to specifically include recent developments in e-health was acknowledged, as well as the importance of addressing differences between settings and including developing countries.

METHODS

a steering committee was assembled and 10 working Groups were created to provide preliminary evidence-based recommendations. A cross-cutting theme on patient's perspective was also created. In addition, a worldwide multidisciplinary group of experts and stakeholders, to review the proposed recommendations and to participate in a Delphi process to achieve consensus for the final recommendations, was brought together.

CONCLUSION

in this New Horizons article, the global challenges in falls prevention are depicted, the goals of the worldwide task force are summarised and the conceptual framework for development of a global falls prevention and management guideline is presented.

摘要

背景

老年人中常见跌倒和与跌倒相关的伤害,对生活质量和功能独立性都有负面影响,并且与发病率、死亡率和医疗保健成本的增加有关。目前,各国和各地的临床方法和跌倒指南建议差异很大,因此需要采用标准化方法。在 2019 年 12 月于马来西亚吉隆坡举行的第一届世界跌倒和姿势不稳大会上,一个由致力于通过纳入跌倒研究中的当前和新兴证据来更新跌倒预防和管理临床实践指南以实现全球共识的全球老年人跌倒专家组成的全球工作组,承诺实现全球共识。此外,人们认识到采取以人为本的方法并纳入患者、护理人员和其他利益相关者的观点是这项工作的重要组成部分。最后,人们认识到有必要特别纳入最近在电子健康方面的发展,并解决不同环境之间的差异,包括发展中国家。

方法

成立了一个指导委员会,并创建了 10 个工作组,以提供初步的基于证据的建议。还创建了一个关于患者视角的跨领域主题。此外,还召集了一个由全球多学科专家和利益相关者组成的小组,以审查拟议的建议,并参与德尔菲流程以就最终建议达成共识。

结论

在这篇新视野文章中,描绘了预防跌倒的全球挑战,总结了全球工作组的目标,并提出了制定全球跌倒预防和管理指南的概念框架。

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