転倒ならびに転倒による骨折は，寝たきり，要介護状態の悪化，死亡率の増加をもたらす危険因子の１つであり，高齢者の転倒予防は非常に重要な課題である．本研究では、転倒予防策の１つである転倒リスクアセスメントツールの開発を目指して、日本の介護施設の1種であるサービス付き高齢者向け住宅において発生する転倒のリスク因子を明らかにすることを目的とした。本邦のサービス付き高齢者向け住宅において2018年1月〜2月に転倒した入居者76名に対し、非転倒者360名を性別と年齢を用いてマッチングさせ、各群の服用薬剤の違いについて、単変量解析、多変量ロジスティック回帰により検討した。服用薬剤は、薬価基準収載医薬品コードの上3桁を用いて、薬効分類ごとにカテゴリ分けした。転倒者と非転倒者の服用薬剤ごとに単変量解析を行ったところ，その他の血液・体液用剤，その他の消化器官用薬，その他の中枢神経系用薬，その他の泌尿生殖器官及び肛門用薬，下剤・浣腸剤，解熱鎮痛消炎剤，眼科用剤，去たん剤，血液凝固防止剤，抗てんかん剤，合成抗菌剤，催眠鎮静剤・抗不安剤，消化性潰瘍用剤，制酸剤，精神神経用剤，他に分類されない代謝性医薬品，鎮痛・鎮痒・修練・消炎剤，糖尿病用剤，利尿薬の19種類の服用薬剤において，有意な差が見られた．これらの因子、ならびに、入居者の介護度を用いて多変量ロジスティック回帰を実施したところ、下剤・浣腸剤，抗てんかん剤について転倒発生のオッズが増加した。本結果より、転倒発生には酸化マグネシウムなどの下剤・浣腸剤や抗てんかん剤が寄与することが考えられたが、今回の検討ではイベント発生サンプル数が76と説明変数の数に比べて少なかったことから、対象者を増やして引き続き検討を行う必要がある。
Falls and fractures caused by falls are one of the risk factors that lead to bedridden, increased care needs, and increased mortality. Thus, the prevention of falls in the elderly is a very important issue. In this study, I examined risk factors for falls occurring in senior housing with care services, a type of assisted living facilities in Japan, with the aim of developing a fall risk assessment tool as one of the measures to prevent falls. Seventy-six residents who fell in January-February 2018 in senior housing in Japan were matched with 360 non-fallers using gender and age, and the differences in medications taken by each group were examined using univariate analysis and multivariate logistic regression. The medications were categorized by drug class. Univariate analysis of each drug taken by fallers and non-fallers showed that there were significant differences in 19 types of following medications: other blood and body fluid drugs, other gastrointestinal drugs, other central nervous system drugs, other urogenital and anal drugs, laxatives, antipyretic analgesics and anti-inflammatory drugs, ophthalmic drugs, expectorant, anticoagulants, antiepileptics, synthetic antibacterials, sedatives and anxiolytics. peptic ulcer medications, antacids, neuropsychiatric medications, metabolic medications not elsewhere classified, analgesic/antipruritic/healing/antiphlogistic agents, diabetic agents, and diuretics. Multivariate logistic regression using these factors, as well as the residents' level of care, showed that the odds of fall occurrence increased for laxative drugs and antiepileptic drugs. The results may suggest that laxative drugs such as magnesium oxide and antiepileptic drugs contribute to the occurrence of falls. However, the number of event occurrence samples in this study was 76, which was too small compared to the number of explanatory variables. It is necessary to increase the number of targets that caused falls.