老年人跌倒之危險因子、評估、及預防

Risk Factors, Evaluation and Prevention of Falls in Older Adults

李宗育(Zong-Yu Li) ； 陸鳳屏(Feng-Ping Lu) ； 詹鼎正(Ding-Cheng Chan)

《內科學誌》 25卷3期 (2014/06) Pp. 137-142

https://doi.org/10.6314/JIMT.2014.25(3).02

摘要

台灣已進入高齡化社會，跌倒在老年人是重要的健康議題，不僅造成老年人的身體傷害、住院甚至死亡，也帶給醫療體系及家庭龐大的照護負擔。跌倒發生的原因相當複雜，包括內在因素及外在因素，例如老化造成的身體功能退化、急慢性疾病、藥物、及居家環境安全等，都和跌倒的發生有關。針對有步態平衡異常者及已發生兩次以上跌倒的老年人，需要進行跌倒危險因子的詳細評估，藉由適當的病史及用藥史詢問、理學檢查、神經學檢查等，能找出跌倒的危險因子進行介入。常見的老年跌倒預防方式，包括運動訓練、藥物調整、維生素D的補充、及居家環境改善等。配合多重因子的介入，能減少老年跌倒的發生及相關傷害，提高老人的生活品質，降低對醫療體系及家庭照顧的負擔。

關鍵字

跌倒（Falls） ； 老年人（Elderly） ； 流行病學（Epidemiology） ； 危險因子（Risk factors） ； 預防（Prevention）

並列摘要

Falls in the elderly is an important health issue. Falls not only cause bodily injury, hospitalization and even death in the elderly, but also bring enormous burden on the health system and caregivers. Causes of falls in older persons are complex and often involve internal and external factors, such as aging-related degeneration of organ systems, chronic diseases, medications, and environmental factors. A multifactorial fall risk assessment should be performed for community-dwelling older persons who report recurrent (2 or more) falls, report difficulties with gait or balance, or seek medical attention because of a fall. Through targeted medical history, medication review, physical and neurological examinations, physicians can identify the risk factors of falls in an older adult. The strategies of fall prevention include exercise training, modification of medications, vitamin D supplement, and environmental improvement in the home. Multifactorial interventions can reduce the occurrence of falls and related injuries in the elderly, improve elderly people's quality of life and reduce the burden on healthcare and family care.