老年跌倒干预措施效果的Meta分析

[目的]评价各种锻炼、家居环境危险因素调整和多因素评估与干预在预防老年跌倒上的效应大小。[方法]通过检索Medline、Cochrane Database of Systematic Reviews、Cochrane Central Register of Controlled Trials、《中国生物医学文献数据库》(CBMdisc)与其他数据库及追溯参考文献收集与老年跌倒预防有关的随机对照试验,按入选标准筛选后提取其中的数据进行Meta分析。[结果]共有25篇文献收录。Meta分析显示,锻炼在预防老年跌倒发生上,总RR为0.885,95%CI为(0.808,0.970);在预防创伤性跌倒的发生上,总RR(95%CI)为0.675(0.511,0.892)。家居环境危险因素调整在预防全老年人群上总RR(95%CI)为0.854(0.751,0.972);在预防有跌倒史的老年人群上总RR(95%CI)为0.659(0.537,0.808)。多因素评估及干预在预防老年跌倒和创伤性跌倒上,总效应RR(95%CI)分别为0.817(0.688,0.969)和0.764(0.595,0.981)。[结论]锻炼、家居环境危险因素调整和多因素评估及干预都可以减少老年跌倒或创伤性跌倒的发生。

Interventions for the Prevention of Falls in Older Adults: A Meta-analysis of Randomized Control Trials

[Objective] To assess the relative effectiveness of intervention,including exercises,home hazard modification and multifactorial assessment and intervention to prevent falls in older adults.[ Methods] Medline,Cochrane Database of Systematic Reviews,Cochrane Central Register of Controlled Trials,CBMdisc,other related databases and reference lists were the data sources. The Meta-analysis was operated to the data from the selected papers.[ Results] 25 papers were identified. The combining exercise intervention trials with risk ratio data showed a reduction in the risk of falling,risk ratio(RR)= 0.885, 95% confidence interval(95%CI):0.808-0.970,and in the risk of injurious falling(RR=0.675,95%CI:0.511-0.892). Home hazard modification has a benefit effect on the risk of falling for the unselected elderly(RR=0.854,95%CI:0.751-0.972) and the elderly with a fall history(RR=0.659,95%CI:0.537-0.808). Multifactorial assessment and intervention also played an important role in the reduction of the risk of falling(RR=0.817,95%CI:0.688-0.969) and the risk of injurious falling(RR=0.764, 95%CI:0.595-0.981).[ Conclusion] Exercises,home hazard modification and multifactorial assessment and intervention are all effective in reducing the risk of falling and injurious falling in older adults.