影响中国老年人跌倒疾病相关危险因素的Meta分析

Risk factors associated with diseases influence falls among the elderly in China:a meta-analysis

目的利用Meta分析方法探究影响中国老年人跌倒的疾病相关影响因素。方法通过计算机检索中国学术期刊网络出版总库、中国生物医学文献数据库(CBM)、维普中文生物医学期刊数据库、万方数据库及英文数据库Medlinne、Pubmed、Embase等数据库,收集建库至2016年5月在国内外期刊公开发表的研究中国老年人跌倒影响因素的相关文献,使用Stata12.0软件进行Meta分析。结果 Meta分析显示,影响中国老年人跌倒的危险因素为既往跌倒史[OR(95%CI)=7.43(4.13~10.73)]、高血压[OR(95%CI)=1.84(1.52~2.15)]、脑卒中[OR(95%CI)=2.61(1.16~4.05)]、糖尿病[OR(95%CI)=1.92(1.16~2.70)]、骨关节炎[OR(95%CI)=1.68(1.38~1.97)]、痴呆[OR(95%CI)=4.35(3.41~5.29)]、跌倒恐惧[OR(95%CI)=1.72(1.04~2.40)]、抑郁[OR(95%CI)=1.84(1.16~2.52)]以及服用精神类药物[OR(95%CI)=2.33(1.75~2.92)];而体位性低血压[OR(95%CI)=2.73(0.95~4.51)]与跌倒的关联无显著性意义。结论服用精神类药物、跌倒史、痴呆、骨关节炎、高血压、脑卒中、糖尿病、跌倒恐惧以及抑郁是老年人跌倒的危险因素;体位性低血压对跌倒的影响尚不明确,缺乏大样本前瞻性研究数据支持。

Objective The aim of this study was to explore the risk factors associated with diseases that influence falls among the elderly in China using meta-analysis techniques. The ultimate goal of this research was to learn about these risk factors and to obtain data that can be used to prevent falls and reduce fall-related injuries. Methods We performed online searches of the CBM, Wanfang, VIP, CNKI, Medline, Pubmed, and Embase databases in May 2016 to find studies of risk factors for falls among the elderly in China. Stata 12.0 software was used to perform the meta-analysis. Results A total of 16 studies were included in this meta-analysis. The results show that the risk factors for falling with significant differences were a history of falling, hypertension, stroke, diabetes, osteoarthritis, dementia, fear of falling, depression and the use of psychiatric medications. The odds ratios and 95%confidence intervals were 7.43 （4.13 ~ 10.73）,1.84 （1.52 ~ 2.15）,2.61 （1.16 ~ 4.05）,1.92 （1.16 ~ 2.70）,1.68 （1.38 ~ 1.97）,4.35 （3.41 ~ 5.29）,1.72 （1.04 ~ 2.40）,1.84 （1.16 ~ 2.52）,and 2.33 （1.75 ~ 2.92）. The postural hypotension OR （95% CI）was 2.73 （0.95 ~4.51）,with no significant difference. Conclusion A history of falling,hypertension,stroke,diabetes,osteoarthritis,dementia,fear of falling,depression and the use of psychiatric medications are risk factors for falling. The relationship between postural hypotension and falls is not clear,which indicates a need for further study through larger prospective studies.