Drugs and falls in older people: A systematic review and meta-analysis: I. Psychotropic drugs
Drugs and falls in older people: A systematic review and meta-analysis: I. Psychotropic drugs
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DOI：
10.1111/j.1532-5415.1999.tb01898.x
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发表时间：
1999-01-01
影响因子：
6.3
通讯作者：
Tinetti, ME
中科院分区：
文献类型：
--
作者：
Leipzig, RM;Cumming, RG;Tinetti, ME
目的：对精神药物与老年人福尔斯跌倒相关的证据进行批判性评价。设计：固定效应荟萃分析。资料来源：MEDLINE中的英文文献（1966年-1996年3月）根据事故或意外福尔斯和年龄或年龄因素检索;检索论文的参考书目。对60岁及以上人群使用镇静/催眠药、抗抑郁药或神经安定药伴跌倒的系统评价。研究设计、纳入和排除标准、设置、样本量、应答率、平均年龄、药物验证和跌倒评估的方法、跌倒定义以及服用特定类别精神药物的跌倒者和非跌倒者的数量。40项研究（无随机对照试验）符合入选标准。对于一次或多次福尔斯，（95%置信区间）为1.73（95% CI，1.52-1.97）任何精神药物使用; 1.50（95% CI，1.25-1.79）使用抗精神病药; 1.54（95% CI，1.40-1.70）用于镇静/催眠; 1.66（95% CI，1.4-1.95）任何抗抑郁药使用（主要是三氯乙酸）; 1.51（95% CI，1.14-2.00）;使用苯二氮卓类药物为1.48（95% CI，1.23-1.77），短效和长效苯二氮卓类药物之间无差异。对于精神病住院患者使用抗精神病药物，合并OR为0.41（95%CI，0.21- 0.82）;对于所有其他患者，合并OR为1.66（95%CI，1.38-2.00）。比较大于或等于1次跌倒与大于或等于2次福尔斯跌倒，平均受试者年龄
OBJECTIVES: To evaluate critically the evidence linking psychotropic drugs with falls in older people.DESIGN: Fixed-effects meta-analysis.DATA SOURCES: English-language articles in MEDLINE (1966 - March 1996) indexed under accidents or accidental falls and aged or age factors; bibliographies of retrieved papers.STUDY SELECTION: Systematic evaluation of sedative/hypnotic, antidepressant, or neuroleptic use with falling in people aged 60 and older.DATA EXTRACTION: Study design, inclusion and exclusion criteria, setting, sample size, response rate, mean age, method of medication verification and fall assessment, fall definition, and the number of fallers and non-fallers taking specific classes of psychotropic drugs.RESULTS: Forty studies, none randomized controlled trials, met eligibility criteria. For one or more falls, the pooled odds ratio (95% confidence interval) was 1.73 (95% CI, 1.52-1.97) for any psychotropic use; 1.50 (95% CI, 1.25-1.79) for neuroleptic use; 1.54 (95% CI, 1.40-1.70) for sedative/hypnotic use; 1.66 (95% CI, 1.4-1.95) for any antidepressant use (mainly TCAs); 1.51 (95% CI, 1.14-2.00) for only TCA use; and 1.48 (95% CI, 1.23-1.77) for benzodiazepine use, with no difference between short and long acting benzodiazepines. For neuroleptics in psychiatric inpatients, the pooled OR was 0.41 (95% CI, 0.21-.82); for all other patients, the pooled OR was 1.66 (95% CI, 1.38-2.00). Comparing greater than or equal to 1 with greater than or equal to 2 falls, mean subject age