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Does baseline depression increase the risk of unexplained and accidental falls in a cohort of community‐dwelling older people? Data from The Irish Longitudinal Study on Ageing (TILDA)
Author(s) -
Briggs Robert,
Kennelly Sean P.,
Kenny Rose Anne
Publication year - 2018
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.4770
Subject(s) - depression (economics) , medicine , poison control , longitudinal study , epidemiology , cohort , falls in older adults , cohort study , injury prevention , odds ratio , late life depression , logistic regression , geriatric depression scale , demography , ageing , gerontology , psychiatry , depressive symptoms , medical emergency , cognition , pathology , sociology , economics , macroeconomics
Background Depression independently increases the risk of falls in older people, but the mechanism for this relationship, as well as the specific falls type involved, remains unclear. Accidental falls (AFs) are due to slips or trips, while the cause of unexplained falls (UFs) is not immediately apparent and can include unrecognised syncope. Method This longitudinal study examines the relationship between baseline depression and subsequent falls, both accidental and unexplained, at 2‐year follow‐up in a cohort of community dwelling adults aged ≥50 years. Baseline depression was defined as a score ≥16 on The Centre for Epidemiological Studies Depression Scale. At follow‐up, participants were assessed regarding falls since last interview. Results One‐third (228/647) of the depressed group had fallen at follow‐up, compared with 22% (1388/6243) of the nondepressed group ( P < .001). Multiple logistic regression models demonstrated that depression was associated with an odds ratio of 1.58 (1.31‐1.89) P < .001; 1.24 (1.00‐1.52), P = .046; and 1.89 (1.45‐2.46), P < .001 for total falls, AFs and UFs, respectively, after controlling for relevant covariates. Participants with depression who fell were more likely to have prior falls, functional impairment and slower gait when compared with depressed participants who did not fall. Discussion The risk of falls associated with depression in older adults is more marked for UFs, with the association for AFs approaching borderline significance only. This finding is important because UFs require focused clinical assessment with attention to potential causes such as cardiac arrhythmia or orthostatic hypotension.