American Geriatrics Society response to the World Falls Guidelines.
American Geriatrics Society response to the World Falls Guidelines.
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美国老年病学协会对《世界跌倒指南》的回应。
DOI：
10.1111/jgs.18734
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发表时间：
2023
影响因子：
6.3
通讯作者：
Phelan,Elizabeth
中科院分区：
文献类型：
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作者：
Eckstrom,Elizabeth;Vincenzo,JenniferL;Casey,ColleenM;Gray,Shelly;Cosley,Kristina;Caulley,Jamie;Parulekar,Manisha;Rasheed,Anita;Sanon,Martine;Demiris,George;Zimbroff,Robbie;DeLima,Bryanna;Phelan,Elizabeth
在65岁及以上的 成年人中，跌倒是可预防的死亡、受伤和独立性降低的主要原因。美国老年医学会和英国老年医学会(AGS/BGS)于2001年发布了一份指南，2011年修订了该指南，解决了跌倒的常见风险因素，并提供了降低社区老年人跌倒风险的建议。2022年，世界瀑布指南(WFG)工作组为老年人创建了最新的、面向全球的跌倒预防风险分层、评估、管理和干预措施。我们的目标是简要总结新的WFG，将它们与AGS/BGS指南进行比较，并提供在美国实施的建议。我们审查了12个WFG主题中的11个与社区居住的老年人有关，并同意先前AGS/BGS指南的几个补充内容，包括对听力障碍和跌倒的关注的评估和干预，有认知障碍的老年人的评估和个性化锻炼，以及在开出可能会增加跌倒风险的药物之前进行标准化评估，如STOPPFall。值得注意的不同之处包括：(1)AGS继续建议每年对所有65岁以上的患者进行跌倒筛查，而不仅仅是那些有跌倒病史或通过机会性病例发现进行筛查的患者；(2)AGS建议继续使用Timed Up and Go作为步态评估，而不是依赖步态速度；以及(3)AGS建议临床判断是否为有跌倒风险的人检查心电图。我们针对美国观众对WFG的审查和翻译为医疗保健和其他提供者和团队提供了指导，以降低老年人的跌倒风险。
Falls are a major cause of preventable death, injury, and reduced independence in adults aged 65 years and older. The American Geriatrics Society and British Geriatrics Society (AGS/BGS) published a guideline in 2001, revised in 2011, addressing common risk factors for falls and providing recommendations to reduce fall risk in community‐dwelling older adults. In 2022, the World Falls Guidelines (WFG) Task Force created updated, globally oriented fall prevention risk stratification, assessment, management, and interventions for older adults. Our objective was to briefly summarize the new WFG, compare them to the AGS/BGS guideline, and offer suggestions for implementation in the United States. We reviewed 11 of the 12 WFG topics related to community‐dwelling older adults and agree with several additions to the prior AGS/BGS guideline, including assessment and intervention for hearing impairment and concern for falling, assessment and individualized exercises for older adults with cognitive impairment, and performing a standardized assessment such as STOPPFall before prescribing a medication that could potentially increase fall risk. Notable areas of difference include: (1) AGS continues to recommend screening all patients aged 65+ annually for falls, rather than just those with a history of falls or through opportunistic case finding; (2) AGS recommends continued use of the Timed Up and Go as a gait assessment, rather than relying on gait speed; and (3) AGS recommends clinical judgment on whether or not to check an ECG for those at risk for falling. Our review and translation of the WFG for a US audience offers guidance for healthcare and other providers and teams to reduce fall risk in older adults.