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fall prevention
Fall prevention is a variety of actions to help reduce the number of accidental falls suffered by older people.
Falls and fall related injuries are among the most serious and common medical problems experienced by older adults. Nearly one-third of older persons fall each year, and half of them fall more than once.〔Moylan KC, Binder EF. Falls in older adults: risk assessment, management and prevention. ''Am J Med''. 2007;120(6):493.e1-6. PMID 17524747〕 Because of underlying osteoporosis and decreased mobility and reflexes, falls often result in hip fractures and other fractures, head injuries, and even death in older adults. Accidental injuries are the fifth most common cause of death in older adults.〔 In around 75% of hip fracture patients, recovery is incomplete and overall health deteriorates.〔
The most consistently proven predictors of fall risk are history of a fall during the past year and gait and balance abnormalities.〔Ganz DA, Bao Y, Shekelle PG, Rubenstein LZ. Will my patient fall? JAMA. 2007;297(1):77-86. PMID 17200478〕 Some studies (but not others) indicated that impaired vision, certain medications (especially psychotropic drugs),〔Hartikainen S, Lönnroos E, Louhivuori K. Medication as a risk factor for falls: critical systematic review. ''J Gerontol A Biol Sci Med Sci''. 2007;62(10):1172-81. PMID 17921433〕 decreased activities of daily living and impaired cognition are associated with a higher risk of falls. The contribution of orthostatic hypotension to fall risk remains uncertain.〔
== Fall Prevention Strategies and Interventions ==
Research indicates that multifactorial intervention programs can reduce the number of falls; in a meta-analysis of studies of older people in general the reduction was around 27%, and in those selected because of a previous fall or other risk factor there was a 14% reduction.〔Gillespie LD, Gillespie WJ, Robertson MC, Lamb SE, Cumming RG, Rowe BH. Interventions for preventing falls in elderly people. Cochrane Database Syst Rev. 2003;(4):CD000340. (Full text )〕 Although further research is needed, preventative measures with the greatest likelihood of a positive effect include strength and balance training, home risk assessment, withdrawing psychotropic medication, cardiac pacing for those with carotid sinus hypersensitivity, and T'ai chi.〔 T'ai chi exercises have been shown to provide 47% reduction in falls in some studies but it does not improve measures of postural stability. T'ai chi may gain its success, in part, from promoting confidence rather than primarily reducing the postural instability. () Assistive technology can also be applied, although it is mostly reactive in case of a fall.
抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』
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