本文由小咖机器人翻译整理

期刊来源：JAMA

原文链接：https://doi.org/10.1001/jama.2024.8481

摘要内容如下：

重要性

跌倒是美国老年人伤害相关发病率和死亡率的主要原因。2018年，居住在社区的65岁及以上的成年人中，27.5%的人报告在过去一年中至少有一次跌倒，10.2%的人报告与跌倒有关的伤害。2021年，估计有38742人死于与跌倒有关的伤害。

目的

美国预防服务工作组（USPSTF）委托进行了一项系统审查，以评估初级保健相关干预措施在预防社区居住的65岁及以上成年人跌倒和跌倒相关发病率和死亡率方面的有效性和危害。

人口

居住在社区的65岁或以上的成年人跌倒风险增加。

证据评估

USPSTF得出的结论具有一定的确定性，即运动干预在预防跌倒风险增加的老年人的跌倒和跌倒相关发病率方面提供了一定的净效益。USPSTF的结论是，多因素干预措施在预防跌倒风险增加的老年人的跌倒和跌倒相关发病率方面提供了较小的净效益。

推荐

USPSTF建议对社区居住的65岁或以上的成年人进行运动干预，以预防跌倒，这些人的跌倒风险较高。（B建议）USPSTF建议临床医生对社区居住的65岁或以上跌倒风险增加的成年人进行个体化决策，以提供多因素干预措施来预防跌倒。现有证据表明，常规提供多因素干预预防跌倒的总体净效益很小。在确定这项服务是否适合个人时，患者和临床医生应根据之前跌倒的情况、是否存在共病的医疗条件以及患者的价值观和偏好来考虑利弊。（C）建议。

英文原文如下：

Abstracts

Importance  Falls are the leading cause of injury-related morbidity and mortality among older adults in the US. In 2018, 27.5% of community-dwelling adults 65 years or older reported at least 1 fall in the past year and 10.2% reported a fall-related injury. In 2021, an estimated 38 742 deaths resulted from fall-related injuries.

Objective  The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the effectiveness and harms of primary care-relevant interventions to prevent falls and fall-related morbidity and mortality in community-dwelling adults 65 years or older.

Population  Community-dwelling adults 65 years or older at increased risk of falls.

Evidence Assessment  The USPSTF concludes with moderate certainty that exercise interventions provide a moderate net benefit in preventing falls and fall-related morbidity in older adults at increased risk for falls. The USPSTF concludes with moderate certainty that multifactorial interventions provide a small net benefit in preventing falls and fall-related morbidity in older adults at increased risk for falls.

Recommendation  The USPSTF recommends exercise interventions to prevent falls in community-dwelling adults 65 years or older who are at increased risk for falls. (B recommendation) The USPSTF recommends that clinicians individualize the decision to offer multifactorial interventions to prevent falls to community-dwelling adults 65 years or older who are at increased risk for falls. Existing evidence indicates that the overall net benefit of routinely offering multifactorial interventions to prevent falls is small. When determining whether this service is appropriate for an individual, patients and clinicians should consider the balance of benefits and harms based on the circumstances of prior falls, presence of comorbid medical conditions, and the patient's values and preferences. (C recommendation).

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