漸進式行動力減退合併反覆跌倒在一個視力障礙的長者

Progressive Decline in Mobility and Frequent Falls in an Elderly Patient with Visual Impairment

10.29461/TGGa.202311_18(4).0007

楊敬譽(Ching-Yu Yang)；曾祥洸(Hsiang-Kuang Tseng)

行動力 ； 跌倒 ； 周全性老年評估 ； 視力障礙 ； 常壓性水腦 ； mobility ； falls ； comprehensive geriatric assessment ； visual impairment ； normal pressure hydrocephalus

台灣老年醫學暨老年學會雜誌

18卷4期（2023 / 11 / 01）

325 - 335

繁體中文;英文

本文介紹一名71歲男性，患有雙眼視力障礙、糖尿病、慢性腎病變，近一年來行動力持續下降，一個月內發生兩次跌倒。經病史詢問、相關檢查與周全性老年評估後，發現常壓性水腦症、周邊神經病變與多重用藥等問題。藉由本案可知，行動力下降與跌倒的發生是多重因素造成，透過本跨專業團隊評估，找出可以治療的病因，適度控制慢性疾病，針對視力障礙等無法治癒的病因，則透過改善環境或應用外在輔具，減少跌倒的再發生率，希冀提升患者的生活品質，避免失能的發生。

This report describes the case of a 71-year-old man with visual impairment, diabetes mellitus, and chronic kidney disease; the patient had experienced progressive decline in mobility over the past year and two falling incidents in the month prior to presentation. We first reviewed the patient's medical history and proceeded to conduct serial examinations and comprehensive geriatric assessment, identifying problems such as normal pressure hydrocephalus, polyneuropathy, and polypharmacy. As the case indicated, declining mobility and frequent falls are often caused by a combination of factors. Therefore, collaborating with an interdisciplinary team, we were able to identify treatable medical conditions and effectively manage chronic diseases in the patient. For untreatable conditions, such as visual impairment, we recommended improving living environment and utilizing assistive devices to reduce recurrent falls, enhance quality of life, and prevent disability.