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多系统受累老年患者平衡障碍所致跌倒:发病机制与治疗策略

Falls caused by balance disorders in the elderly with multiple systems involved: Pathogenic mechanisms and treatment strategies.

作者信息

Xing Liwei, Bao Yi, Wang Binyang, Shi Mingqin, Wei Yuanyuan, Huang Xiaoyi, Dai Youwu, Shi Hongling, Gai Xuesong, Luo Qiu, Yin Yong, Qin Dongdong

机构信息

School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming Yunnan, China.

The First Clinical Medical School, Yunnan University of Chinese Medicine, Kunming Yunnan, China.

出版信息

Front Neurol. 2023 Feb 23;14:1128092. doi: 10.3389/fneur.2023.1128092. eCollection 2023.

Abstract

Falls are the main contributor to both fatal and nonfatal injuries in elderly individuals as well as significant sources of morbidity and mortality, which are mostly induced by impaired balance control. The ability to keep balance is a remarkably complex process that allows for rapid and precise changes to prevent falls with multiple systems involved, such as musculoskeletal system, the central nervous system and sensory system. However, the exact pathogenesis of falls caused by balance disorders in the elderly has eluded researchers to date. In consideration of aging phenomenon aggravation and fall risks in the elderly, there is an urgent need to explore the pathogenesis and treatments of falls caused by balance disorders in the elderly. The present review discusses the epidemiology of falls in the elderly, potential pathogenic mechanisms underlying multiple systems involved in falls caused by balance disorders, including musculoskeletal system, the central nervous system and sensory system. Meanwhile, some common treatment strategies, such as physical exercise, new equipment based on artificial intelligence, pharmacologic treatments and fall prevention education are also reviewed. To fully understand the pathogenesis and treatment of falls caused by balance disorders, a need remains for future large-scale multi-center randomized controlled trials and in-depth mechanism studies.

摘要

跌倒既是老年人致命和非致命伤害的主要原因,也是发病和死亡的重要因素,其主要由平衡控制受损引起。保持平衡的能力是一个极其复杂的过程,涉及多个系统(如肌肉骨骼系统、中枢神经系统和感觉系统)的快速精确变化以防止跌倒。然而,迄今为止,研究人员尚未明确老年人平衡障碍导致跌倒的确切发病机制。鉴于老年人衰老现象加剧和跌倒风险增加,迫切需要探索老年人平衡障碍导致跌倒的发病机制和治疗方法。本综述讨论了老年人跌倒的流行病学、平衡障碍导致跌倒所涉及的多个系统(包括肌肉骨骼系统、中枢神经系统和感觉系统)潜在的致病机制。同时,还综述了一些常见的治疗策略,如体育锻炼、基于人工智能的新设备、药物治疗和预防跌倒教育。为了全面了解平衡障碍导致跌倒的发病机制和治疗方法,未来仍需要大规模多中心随机对照试验和深入的机制研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d9b9/9996061/6cdb95e73769/fneur-14-1128092-g0001.jpg

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