Polypharmacy as a risk for fall occurrence in geriatric outpatients

被引:164
作者
Kojima, Taro
Akishita, Masahiro [1 ]
Nakamura, Tetsuro [2 ]
Nomura, Kazushi
Ogawa, Sumito
Iijima, Katsuya
Eto, Masato
Ouchi, Yasuyoshi
机构
[1] Univ Tokyo, Grad Sch Med, Dept Geriatr Med, Bunkyo Ku, Tokyo 1138655, Japan
[2] Res Inst Aging Sci, Tokyo, Japan
关键词
bone; musculo-skeletal; elderly; falls; geriatric medicine; internal medicine; polypharmacy; DWELLING OLDER PERSONS; NURSING-HOME RESIDENTS; ELDERLY PERSONS; COMMUNITY; METAANALYSIS; PEOPLE; DRUGS; INJURIES;
D O I
10.1111/j.1447-0594.2011.00783.x
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Objective: To investigate the predictors of falls, such as comorbidity and medication, in geriatric outpatients in a longitudinal observational study. Methods: A total of 172 outpatients (45 men and 126 women, mean age 76.9 +/- 7.0 years) were evaluated. Physical examination, clinical history and medication profile were obtained from each patient at baseline. These patients were followed for up to 2 years and falls were self-reported to their physicians. The factors associated with falls were analyzed statistically. Results: A total of 32 patients experienced falls within 2 years. On univariate analysis, older age, osteoporosis, number of comorbid conditions and number of drugs were significantly associated with falls within 2 years. On multiple logistic regression analysis, the number of drugs was associated with falls, independent of age, sex, number of comorbid conditions and other factors that were significantly associated in univariate analysis. A receiveroperator curve evaluating the optimal cut-off value for the number of drugs showed that taking five or more drugs was a significant risk. Conclusion: In geriatric outpatients, polypharmacy is associated with falls. Intervention studies are needed to clarify the causal relationship between polypharmacy, comorbidity and falls. Geriatr Gerontol Int 2012; 12: 425430.
引用
收藏
页码:425 / 430
页数:6
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