Koski K, Luukinen H, Laippala P, Kivela S L
Department of Public Health Science and General Practice, University of Oulu, Aapiste 1, FIN-90220 Oulu, Finland.
Age Ageing. 1996 Jan;25(1):29-38. doi: 10.1093/ageing/25.1.29.
To determine the physiological factors and medications predicting injurious falls among the elderly population, the authors conducted a prospective study in a rural home-dwelling population aged 70 years or over, initially 979 persons (377 men and 602 women), from 1 January 1991 to 31 December 1992, in Northern Finland. The independent risk factors for all falling injuries, falls leading to minor injuries and ones leading to major injuries were determined. In men, the independent risk factors for all injuries were gait disturbances [odds ratio (OR) = 3.5] and the use of digitalis (OR = 2.2), those for minor injuries were gait disturbances (OR = 2.7) and the use of calcium blockers (OR = 3.0), and those for major injuries were the absence of a quadriceps reflex (OR = 4.8), gait disturbances (OR = 2.8) and the use of digitalis (OR = 2.9). In women, the corresponding independent risk factors were short step length (OR = 32.1), the use of calcium blockers (OR = 2.5) and the use of medications for improving peripheral circulation (OR = 3.7) for all injurious falls, path deviation (OR = 2.3) the use of calcium blockers (OR = 2.8) and the use of anti-inflammatory drugs (OR = 2.1) for minor injuries, and foot deformity (OR = 2.0), short step length (OR = 15.8), the use of long-acting benzodiazepines (OR = 4.0) and the use of calcium blockers (OR = 2.4) for major injuries. In order to prevent injurious falls, attention should be given to the prescription of tranquillizers, cardiovascular medications and anti-inflammatory drugs. The walking abilities of elderly people should be maintained and chronic diseases leading to peripheral neuropathy should be treated adequately.
为确定老年人群中导致伤害性跌倒的生理因素和药物，作者于1991年1月1日至1992年12月31日在芬兰北部对979名年龄在70岁及以上的农村居家老人（最初有377名男性和602名女性）进行了一项前瞻性研究。确定了所有跌倒损伤、导致轻伤的跌倒以及导致重伤的跌倒的独立危险因素。在男性中，所有损伤的独立危险因素是步态障碍（比值比[OR]=3.5）和使用洋地黄（OR=2.2），轻伤的危险因素是步态障碍（OR=2.7）和使用钙通道阻滞剂（OR=3.0），重伤的危险因素是股四头肌反射缺失（OR=4.8）、步态障碍（OR=2.8）和使用洋地黄（OR=2.9）。在女性中，所有伤害性跌倒的相应独立危险因素是步长较短（OR=32.1）、使用钙通道阻滞剂（OR=2.5）和使用改善外周循环的药物（OR=3.7），轻伤的危险因素是路径偏差（OR=2.3）、使用钙通道阻滞剂（OR=2.8）和使用抗炎药（OR=2.1），重伤的危险因素是足部畸形（OR=2.0）、步长较短（OR=15.8）、使用长效苯二氮䓬类药物（OR=4.0）和使用钙通道阻滞剂（OR=2.4）。为预防伤害性跌倒，应注意镇静剂、心血管药物和抗炎药的处方。应维持老年人的行走能力，并充分治疗导致周围神经病变的慢性病。
