Yip Y B, Cumming R G
Department of Public Health, University of Sydney, NSW.
Med J Aust. 1994 Jan 3;160(1):14-8.
To determine whether commonly used medications increase the risk of falling in elderly Australians living in nursing homes.
Case-control study.
A 104-bed nursing home in western Sydney during 1990-1991.
The cases comprised 71 people who had at least one fall during the 12-month study period; 55 people with no falls over the same period served as the control group. The mean age of subjects was 82 years.
Data included medication use in the 24 hours prior to a fall, and assessments of ambulatory status, and gait and balance problems. All data were abstracted from medical records.
After adjusting for potential confounders (age, sex, health status, depression, dementia, incontinence, ambulatory status, gait and balance problems, length of stay and use of other medications), the use of antipsychotics was found to be an important risk factor for falls (odds ratio 4.4, 95% confidence interval 1.2-16.5).
Our results support the conclusion that antipsychotic medications increase the risk of falls among elderly Australians living in nursing homes. Health professionals should minimise the use of these medications.
确定常用药物是否会增加居住在养老院的澳大利亚老年人跌倒的风险。
病例对照研究。
1990 - 1991年悉尼西部一家拥有104张床位的养老院。
病例组包括71名在为期12个月的研究期间至少跌倒过一次的人；同期55名未跌倒的人作为对照组。研究对象的平均年龄为82岁。
数据包括跌倒前24小时内的用药情况，以及对动态状态、步态和平衡问题的评估。所有数据均从医疗记录中提取。
在对潜在混杂因素（年龄、性别、健康状况、抑郁、痴呆、失禁、动态状态、步态和平衡问题、住院时间以及其他药物的使用）进行调整后，发现使用抗精神病药物是跌倒的一个重要危险因素（比值比4.4，95%置信区间1.2 - 16.5）。
我们的结果支持抗精神病药物会增加居住在养老院的澳大利亚老年人跌倒风险这一结论。卫生专业人员应尽量减少这些药物的使用。
