Steinweg K K
East Carolina University School of Medicine, Greenville, North Carolina, USA.
Am Fam Physician. 1997 Nov 1;56(7):1815-23.
The annual incidence of falls is approximately 30 percent in persons over the age of 65 years. The risk of falls is greater in older persons, with the annual incidence increasing to 50 percent in those over age 80. Because of the significant incidence of falls in the elderly, physicians should have an organized approach to fall assessment and prevention. Most falls in the elderly are caused by complex interactions of intrinsic and extrinsic factors. A thorough history is essential to identifying the intrinsic or extrinsic factors involved. Approximately one half of falls in the elderly can be attributed to accidents and extrinsic causes such as slippery floors, and the remainder from intrinsic causes such as lower extremity weakness, gait disorders, effects of medications or acute illness. Extrinsic and intrinsic factors that are identified may be amenable to one of three management approaches: treating acute or reversible deficits, reducing the cumulative burdens of deficits, or using adaptive devices for irreversible deficits. A careful and focused evaluation can identify factors that can be corrected or therapeutic interventions that will lessen the risk of a subsequent fall.
65岁以上人群的年跌倒发生率约为30%。老年人跌倒风险更高，80岁以上人群的年跌倒发生率增至50%。鉴于老年人跌倒发生率很高，医生应采用有条理的方法进行跌倒评估和预防。老年人的大多数跌倒由内在因素和外在因素的复杂相互作用引起。全面的病史对于确定所涉及的内在或外在因素至关重要。老年人约一半的跌倒可归因于意外事故和外在原因，如地面湿滑，其余则由内在原因引起，如下肢无力、步态障碍、药物作用或急性疾病。所确定的外在和内在因素可能适合三种管理方法之一：治疗急性或可逆性缺陷、减轻缺陷的累积负担或为不可逆性缺陷使用适应性装置。仔细且有针对性的评估可以识别出可纠正的因素或能降低后续跌倒风险的治疗干预措施。
