老年人跌倒危险因素的Meta分析

A Meta-analysis of factors affecting falls in the elderly

目的运用Meta分析探讨老年人跌倒的危险因素,为预防老年人跌倒提供循证依据。方法计算机检索PubMed等数据库2018年1月1日至2023年1月1日发表的与老年人跌倒相关的文献。由2名研究者独自筛选文献、提取文献内容、采用NOS量表及AHRQ评价标准进行质量评价。提取数据采用RevMan5.4进行Meta分析。结果本研究共纳入15篇文献,总样本量为26141例,涉及18个相关影响因素。Meta分析结果显示:既往跌倒史(OR=17.85,95%CI 4.83~66.02)、自评健康状况不佳(OR=3.18,95%CI 1.87~5.41;OR=1.36,95%CI 1.16~1.59)、姿势控制能力降低(OR=2.90,95%CI 1.49~5.65)、伴有跌倒相关慢性病(OR=2.77,95%CI 2.20~3.50)、骨质疏松(OR=2.70,95%CI 2.15~3.37)、静动态平衡能力降低(OR=2.65,95%CI 1.49~4.73)、饮酒(OR=2.16,95%CI 1.61~2.90)、害怕跌倒(OR=2.09,95%CI 1.33~3.27)、患关节炎(OR=2.05,95%CI 1.54~1.75)、性别(OR=2.00,95%CI 1.60~2.49)、生活自理能力受损(OR=1.82,95%CI 1.61~2.05)、使用助行器(OR=1.81,95%CI 1.16~2.81)、听力较差(OR=1.54,95%CI 1.29~1.84)、年龄(OR=1.51,95%CI 1.25~1.83)、视力障碍(OR=1.38,95%CI 1.18~1.62)是老年人跌倒的危险因素(P<0.05),防跌设备(OR=0.53,95%CI 0.40~0.71)是其保护因素(P<0.05)。尿失禁对老年人跌倒的影响无统计学意义(P>0.05)。结论证据显示,既往跌倒史、自评健康状况不佳、姿势控制能力降低等因素会增加老年人跌倒风险,使用防跌设备可降低跌倒风险,控制饮酒、使用助行器等可控因素可有效降低老年人群跌倒发生风险。

Objective To explore the risk factors of falls in the elderly by Meta-analysis,and to provide evidence-based evidence for the prevention of falls in the elderly.Methods The literatures related to falls in the elderly published in PubMed and other databases from January 1,2018 to January 1,2023 were searched by computer.Two researchers screened literature,extracted literature content,and used NOS scale and AHRQ evaluation criteria for quality evaluation.Meta analysis was performed using RevMan 5.4 to extract data.Results A total of 15 literatures were included,with a total sample size of 26141 cases,involving 18 related influencing factors.The results of Meta-analysis showed that:previous falls(OR=17.85,95%CI 4.83~66.02),self-rated poor health status(OR=3.18,95%CI 1.87~5.41;OR=1.36,95%CI 1.16~1.59),decreased postural control(OR=2.90,95%CI 1.49~5.65),associated with a fall-related chronic disease(OR=2.77,95%CI 2.20~3.50),osteoporosis(OR=2.70,95%CI 2.15~3.37),decreased static and dynamic balance(OR=2.65,95%CI 1.49~4.73),alcohol consumption(OR=2.16,95%CI 1.61~2.90),fear of falling(OR=2.09,95%CI 1.33~3.27),arthritis(OR=2.05,95%CI 1.54~1.75),gender(OR=2.00,95%CI 1.60~2.49),impaired self-care ability(OR=1.82,95%CI 1.61~2.05),use of a walking aid(OR=1.81,95%CI 1.16~2.81),poor hearing(OR=1.54,95%CI 1.29~1.84),age(OR=1.51,95%CI 1.25~1.83),combined hypertension(OR=1.48,95%CI 1.18~1.85),Visual impairment(OR=1.38,95%CI 1.18~1.62)was a risk factor for falls in the elderly(P<0.05),and anti-fall equipment(OR=0.53,95%CI 0.40~0.71)was a protective factor(P<0.05).There was no statistical significance in the influence of urinary incontinence on falls in the elderly(P>0.05).Conclusion Evidence shows that visual impairment,use of walking AIDS,self-rated poor health status and alcohol consumption increase the risk of falls in the elderly,and fall prevention equipment can reduce the risk of falls.Control of controllable factors can effectively reduce the risk of falls in the elderly population.