Blain Hubert, Annweiler Cédric, Berrut Gilles, Becker Clemens, Bernard Pierre-Louis, Bousquet Jean, Dargent-Molina Patricia, Friocourt Patrick, Martin Finbarr C, Masud Tahir, Petrovic Mirko, Puisieux François, Robiaud Jean-Baptiste, Ryg Jesper, Van der Velde Nathalie, Montero-Odasso Manuel, Rolland Yves
Department of Internal Medicine and Geriatrics, MUSE University, Montpellier, France.
Department of Geriatric Medicine and Memory Clinic, Research Centre on Autonomy and Longevity, University Hospital, Angers, France; Univ Angers, UPRES EA 4638, University of Angers, Angers, France.
Geriatr Psychol Neuropsychiatr Vieil. 2023 Jun 1;21(2):149-160. doi: 10.1684/pnv.2023.1108.
Falls and fall-related injuries are common in older adults, have negative effects on functional independence and quality of life and are associated with increased morbidity, mortality and health related costs.
To synthesize evidence-based and expert consensus-based 2022 world guidelines for the management and prevention of falls in older adults. These recommendations consider a person-centred approach that includes the preferences of the patient, caregivers and other stakeholders, gaps in previous guidelines, recent developments in e-health and both local context and resources.
All older adults should be advised on falls prevention and physical activity. Opportunistic case finding for falls risk is recommended for communitydwelling older adults. An algorithm is proposed to stratify falls risk and interventions for persons at low, moderate or high risk. Those considered at high risk should be offered a comprehensive multifactorial falls risk assessment with a view to co-design and implement personalised multidomain interventions. Other recommendations cover details of assessment and intervention components and combinations, and recommendations for specific settings and populations.
The core set of recommendations provided will require flexible implementation strategies that consider both local context and resources.
跌倒及与跌倒相关的损伤在老年人中很常见,对功能独立性和生活质量有负面影响,且与发病率、死亡率增加以及健康相关费用上升有关。
综合基于证据和专家共识的2022年老年人跌倒管理与预防全球指南。这些建议采用以人为本的方法,包括患者、护理人员和其他利益相关者的偏好、以往指南中的差距、电子健康的最新发展以及当地情况和资源。
应向所有老年人提供预防跌倒和体育活动方面的建议。建议对社区居住的老年人进行跌倒风险的机会性病例发现。提出了一种算法,用于对低、中、高风险人群的跌倒风险进行分层并采取干预措施。对于被认为高风险的人群,应提供全面的多因素跌倒风险评估,以期共同设计并实施个性化的多领域干预措施。其他建议涵盖评估和干预组成部分及组合的详细内容,以及针对特定环境和人群的建议。
所提供的核心建议集将需要灵活的实施策略,该策略要考虑当地情况和资源。