• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文学位 >The Association between Central Nervous System (CNS)-Active Medication Use and Fall-Related Injury in Older Adults with Dementia
【24h】

The Association between Central Nervous System (CNS)-Active Medication Use and Fall-Related Injury in Older Adults with Dementia

机译：老年痴呆症成年人的中枢神经系统（CNS）主动用药与跌倒相关伤害之间的关联

获取原文
获取原文并翻译 | 示例
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Introduction: Few studies have examined the association between central nervous system (CNS)-active medications and fall-related injury in older adults with dementia, a high-risk population. Prior studies have been limited to institutional settings. We evaluated the association between CNS-active medication use and fall-related injury in community-dwelling older adults with dementia.;Methods: The population was community-dwelling older adults aged ≥65 years with a research dementia diagnosis participating in the Adult Changes in Thought Study. From automated pharmacy data, we created a time-varying composite measure of CNS-active medication use, including benzodiazepines/sedatives, anticholinergics, antidepressants, antipsychotics, opioids, and skeletal muscle relaxants. CNS use was classified as: current (≤30 days before fall-related injury), recent (31--90 days before), past (91--365 days before), and non-use. The outcome was fall-related injury based on inpatient and outpatient diagnosis (ICD-9) and injury (E) codes. We calculated standardized daily doses (SDDs) for each CNS-active medication and summed the SDDs across medications. We estimated hazard ratios (HR) with 95% confidence intervals (CI) from Cox models using time since dementia onset as the time axis and adjusting for health and functional characteristics.;Results: Among 793 subjects with dementia, there were 303 fall-related injuries over a mean follow-up of 3.7 years (2,907 total person-years). Relative to non-use, the fall risk (hazard) was significantly higher for current use (HR 1.59; 95% CI 1.19--2.12), but not for past use (HR 0.84; 95% CI 0.55--1.29) or recent use (HR 0.94; 95% CI 0.59--1.69). When estimating a time-varying HR, the contrast in fall hazards between current and no use of CNS-active medications appeared greatest soon after dementia onset. We did not observe significant differences by dose.;Conclusion: Current use of CNS-active medications, but not total dose, was associated with fall-related injuries in community-dwelling older adults with dementia, which appeared greatest soon after dementia diagnosis. Time-varying differences in risk between current users and non-users could be explained by a variety of factors such as more careful prescribing as dementia progresses. Additional examination is needed to further our understanding of these phenomena.
机译：简介：很少有研究检查中枢神经系统（CNS）活性药物与老年痴呆症（高危人群）的跌倒相关损伤之间的关系。先前的研究仅限于机构环境。我们评估了CNS活性药物的使用与社区居住的老年痴呆症患者跌倒相关伤害之间的关联性。方法：该人群是≥65岁的社区居住的老年痴呆症患者，其研究对象为痴呆症的研究对象。思想研究。从自动化药房数据中，我们创建了CNS活性药物使用的时变综合度量，包括苯二氮卓类/镇静剂，抗胆碱能药，抗抑郁药，抗精神病药，阿片类药物和骨骼肌松弛剂。中枢神经系统的使用分类为：当前（跌倒相关伤害之前≤30天），最近（之前31--90天），过去（之前91--365天）和不使用。结果是基于住院和门诊诊断（ICD-9）和伤害（E）代码的跌倒相关伤害。我们计算了每种CNS活性药物的标准每日剂量（SDD），并汇总了各种药物的SDD。我们使用自痴呆症发作以来的时间作为时间轴并根据健康和功能特征进行调整，从Cox模型中以95％的置信区间（CI）评估了危险比（HR）。平均随访3.7年（共2907人/年）。相对于不使用，当前使用的跌倒风险（危险）明显更高（HR 1.59； 95％CI 1.19--2.12），而不是过去使用（HR 0.84； 95％CI 0.55--1.29）或最近使用使用（HR 0.94; 95％CI 0.59--1.69）。估算随时间变化的HR时，痴呆症发作后不久，当前使用和不使用CNS活性药物之间的跌倒危害对比最大。我们没有观察到剂量上的显着差异。结论：目前在社区居住的老年痴呆症患者中，使用CNS活性药物而不是总剂量与跌倒相关的伤害有关，这种情况在痴呆症诊断后不久就出现了。当前使用者和非使用者之间风险随时间变化的差异可以由多种因素来解释，例如随着痴呆症的进展需要更谨慎地开处方。需要进一步检查以进一步了解这些现象。

著录项

  • 作者

    Hart, Laura A.;

  • 作者单位

    University of Washington.;

  • 授予单位 University of Washington.;
  • 学科 Pharmaceutical sciences.;Neurosciences.;Pharmacology.;Gerontology.
  • 学位 Masters
  • 年度 2017
  • 页码 32 p.
  • 总页数 32
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号