《老年人防跌指南》更新

    2011年1月19日，美国和英国老年学会（AGS和BGS）公布了最新版的《老年人防跌指南》。改指南在原有基础上更新了下列内容：

• Multifactorial interventions should always include an exercise component, such as tai chi, physical therapy, or other exercise for balance, gait, and strength training, in group programs or as individual programs at home. Endurance and flexibility training may be prescribed, but not apart from strength training. On the basis of currently available evidence, exercise programs are recommended only for community-dwelling older persons.
• Environmental adaptation by a healthcare professional should be considered to reduce factors in the home and in daily activities that could increase fall risk.
• Cataract surgery should be performed if indicated, but this or other vision intervention should not be administered in isolation apart from a multifactorial assessment and intervention strategy.
• Medication reduction or withdrawal is recommended, particularly for sedatives, antidepressants, and other drugs affecting the central nervous system, regardless of the number of medications prescribed. This is a change from the 2001 guidelines, which recommended reducing medications only if patients were taking 4 or more.
• Orthostatic hypotension, arrhythmias, and heart rate abnormalities should be managed appropriately as part of a multifactorial intervention strategy. Older persons with cardioinhibitory carotid sinus hypersensitivity who have unexplained recurrent falls may benefit from dual-chamber cardiac pacing.
• All older adults at risk for falls, and those with known or suspected vitamin D deficiency, should receive a daily vitamin D supplement (800 IU).