Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-11-25T10:48:13.460Z Has data issue: false hasContentIssue false
  • English
  • Français

Depressive symptoms are independently associated with recurrent falls in community-dwelling older adults

Published online by Cambridge University Press:  23 April 2014

Sébastien Grenier ,
Marie-Christine Payette ,
Francis Langlois ,
Thien Tuong Minh Vu  and
Louis Bherer
Sébastien Grenier*
Affiliation:
Centre de recherche, Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, Québec, Canada
Marie-Christine Payette
Affiliation:
Centre de recherche, Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, Québec, Canada Université du Québec à Montréal (UQAM), Montréal, Québec, Canada
Francis Langlois
Affiliation:
Institut universitaire de gériatrie de Sherbrooke (IUGS), Montréal, Québec, Canada Institut universitaire de gériatrie de Montréal (IUGM), Montréal, Québec, Canada
Thien Tuong Minh Vu
Affiliation:
Institut universitaire de gériatrie de Montréal (IUGM), Montréal, Québec, Canada Centre Hospitalier de l’Université de Montréal (CHUM), Montréal, Québec, Canada
Louis Bherer
Affiliation:
Centre de recherche, Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, Québec, Canada PERFORM Centre, Concordia University, Montréal, Québec, Canada
*
Correspondence should be addressed to: Dr. Sébastien Grenier, Centre de recherche, Institut universitaire de gériatrie de Montréal (CRIUGM), 4565, Queen-Mary Road, Montréal (Québec) H3W 1W5, Canada. Phone: +1-514-340-3540, Ext. 4782; Fax: +1-514-340-2801. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Falls and depression are two major public health problems that affect millions of older people each year. Several factors associated with falls are also related to depressive symptoms such as medical conditions, sleep quality, use of medications, cognitive functioning, and physical capacities. To date, studies that investigated the association between falls and depressive symptoms did not control for all these shared factors. The current study addresses this issue by examining the relationship between falls and depression symptoms after controlling for several confounders.

Methods:

Eighty-two community-dwelling older adults were enrolled in this study. The Geriatric Depression Scale (GDS-30) was used to evaluate the presence of depressive symptoms, and the following question was used to assess falls: “Did you fall in the last 12 months, and if so, how many times?”

Results:

Univariate analyses indicated that the number of falls was significantly correlated with gender (women), fractures, asthma, physical inactivity, presence of depressive symptoms, complaints about quality of sleep, use of antidepressant drugs, and low functional capacities. Multivariate analyses revealed that depressive symptoms were significantly and independently linked to recurrent falls after controlling for confounders.

Conclusions:

Results of the present study highlight the importance of assessing depressive symptoms during a fall risk assessment.

Keywords

older adultsdepressive symptomsrecurrent fallssleep qualitycognitive functioningphysical capacities
Type
Research Article
Information
International Psychogeriatrics , Volume 26 , Issue 9 , September 2014 , pp. 1511 - 1519
Copyright
Copyright © International Psychogeriatric Association 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adams, K. B. and Moon, H. (2009). Subthreshold depression: characteristics and risk factors among vulnerable elders. Aging Mental Health, 13, 682–692.CrossRefGoogle ScholarPubMed
Al-Aama, T. (2011). Falls in the elderly. Canadian Family Physician, 57, 771–776.Google ScholarPubMed
Armstrong, C., Swarbrick, C. M., Pye, S. R. and O’Neill, T. W. (2005). Occurrence and risk factors for falls in rheumatoid arthritis. Annals of the Rheumatic Diseases, 64, 1602–1604.CrossRefGoogle ScholarPubMed
Austin, M. P., Mitchell, P. and Goodwin, G. (2001). Cognitive deficits in depression: possible implications for functional neuropathology. The British Journal of Psychiatry, 178, 200–206.CrossRefGoogle ScholarPubMed
Batra, A., Melchior, M., Seff, L., Frederick, N. and Palmer, R. C. (2012). Evaluation of a community-based falls prevention program in South Florida, 2008–2009. Preventing Chronic Disease, 9, E13.Google ScholarPubMed
Baune, B. T., Suslow, T., Arolt, V. and Berger, K. (2007). The relationship between psychological dimensions of depressive symptoms and cognitive functioning in the elderly – The MEMO Study. Journal of Psychiatric Research, 41, 247–254.CrossRefGoogle ScholarPubMed
Beauchet, O., Fantino, B., Allali, G., Muir, S. W., Montero-Odasso, M. and Annweiler, C. (2011). Timed Up and Go test and risk of falls in older adults: a systematic review. The Journal of Nutrition Health and Aging, 15, 933–938.CrossRefGoogle ScholarPubMed
Beekman, A. T., De Beurs, E., Van Balkom, A. J., Deeg, D. J., Van Dyck, R. and Van Tilburg, W. (2000). Anxiety and depression in later life: co-occurrence and communality of risk factors. The American Journal of Psychiatry, 157, 89–95.CrossRefGoogle ScholarPubMed
Biderman, A., Cwikel, J., Fried, A. V. and Galinsky, D. (2002). Depression and falls among community-dwelling elderly people: a search for common risk factors. Journal of Epidemiology and Community Health, 56, 631–636.CrossRefGoogle ScholarPubMed
Blazer, D. G. (2003). Depression in late life: review and commentary. The Journals of Gerontology Series A: Biological Sciences and Medical, 58, 249–265.CrossRefGoogle Scholar
Bloch, F., Thibaud, M., Dugue, B., Breque, C., Rigaud, A. S. and Kemoun, G. (2010). Episodes of falling among elderly people: a systematic review and meta-analysis of social and demographic pre-disposing characteristics. Clinics (Sao Paulo), 65, 895–903.CrossRefGoogle ScholarPubMed
Bohannon, R. W. (1997). Comfortable and maximum walking speed of adults aged 20–79 years: reference values and determinants. Age and Ageing, 26, 15–19.CrossRefGoogle ScholarPubMed
Brassington, G. S., King, A. C. and Bliwise, D. L. (2000). Sleep problems as a risk factor for falls in a sample of community-dwelling adults aged 64–99 years. Journal of the American Geriatrics Society, 48, 1234–1240.CrossRefGoogle Scholar
Brown, M., Sinacore, D. R., Binder, E. F. and Kohrt, W. M. (2000). Physical and performance measures for the identification of mild to moderate frailty. The Journals of Gerontology Series A: Biological Sciences and Medical, 55, M350–355.CrossRefGoogle ScholarPubMed
Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R. and Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Research, 28, 193–213.CrossRefGoogle ScholarPubMed
Carey, B. J. and Potter, J. F. (2001). Cardiovascular causes of falls. Age and Ageing, 30 (Suppl. 4), 19–24.CrossRefGoogle ScholarPubMed
Cawthon, P. M. et al. (2006). Alcohol intake and its relationship with bone mineral density, falls, and fracture risk in older men. Journal of the American Geriatrics Society, 54, 1649–1657.CrossRefGoogle ScholarPubMed
Chamberlin, M. E., Fulwider, B. D., Sanders, S. L. and Medeiros, J. M. (2005). Does fear of falling influence spatial and temporal gait parameters in elderly persons beyond changes associated with normal aging? The Journals of Gerontology Series A: Biological Sciences and Medical, 60, 1163–1167.CrossRefGoogle ScholarPubMed
Deandrea, S., Lucenteforte, E., Bravi, F., Foschi, R., La Vecchia, C. and Negri, E. (2010). Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiology, 21, 658–668.CrossRefGoogle ScholarPubMed
Delbaere, K., Van Den Noortgate, N., Bourgois, J., Vanderstraeten, G., Tine, W. and Cambier, D. (2006). The Physical Performance Test as a predictor of frequent fallers: a prospective community-based cohort study. Clinical Rehabilitation, 20, 83–90.CrossRefGoogle ScholarPubMed
Enright, P. L. (2003). The six-minute walk test. Respiratory Care, 48, 783–785.Google ScholarPubMed
Everson-Rose, S. A., Skarupski, K. A., Bienias, J. L., Wilson, R. S., Evans, D. A. and De Leon, C. F. M. (2005). Do depressive symptoms predict declines in physical performance in an elderly, biracial population? Psychosomatic Medicine, 67, 609–615.CrossRefGoogle Scholar
Fabre, J. M., Ellis, R., Kosma, M. and Wood, R. H. (2010). Falls risk factors and a compendium of falls risk screening instruments. Journal of Geriatric Physical Therapy, 33, 184–197.CrossRefGoogle Scholar
Ferrer, A., Formiga, F., Plana-Ripoll, O., Tobella, M. A., Gil, A. and Pujol, R. (2012). Risk of falls in 85-year-olds is associated with functional and cognitive status: the Octabaix Study. Archives of Gerontology and Geriatrics, 54, 352–356.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. and Mchugh, P. R. (1975). “Mini-mental state.” A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Grundstrom, A. C., Guse, C. E. and Layde, P. M. (2012). Risk factors for falls and fall-related injuries in adults 85 years of age and older. Archives of Gerontology and Geriatrics, 54, 421–428.CrossRefGoogle ScholarPubMed
Hadjistavropoulos, T., Delbaere, K. and Fitzgerald, T. D. (2011). Reconceptualizing the role of fear of falling and balance confidence in fall risk. Journal of Aging and Health, 23, 3–23.CrossRefGoogle ScholarPubMed
Hayashibara, M., Hagino, H., Katagiri, H., Okano, T., Okada, J. and Teshima, R. (2010). Incidence and risk factors of falling in ambulatory patients with rheumatoid arthritis: a prospective 1-year study. Osteoporosis International, 21, 1825–1833.CrossRefGoogle ScholarPubMed
Heun, R., Papassotiropoulos, A. and Ptok, U. (2000). Subthreshold depressive and anxiety disorders in the elderly. European Psychiatry, 15, 173–182.CrossRefGoogle ScholarPubMed
Hill, E. L., Cumming, R. G., Lewis, R., Carrington, S. and Couteur, D. G. L. (2007). Sleep disturbances and falls in older people. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 62, 62–66.CrossRefGoogle Scholar
Hull, S. L., Kneebone, I. I. and Farquharson, L. (2013). Anxiety, depression, and fall-related psychological concerns in community-dwelling older people. American Journal of Geriatric Psychiatry, 21, 1287–1291.CrossRefGoogle ScholarPubMed
Iaboni, A. and Flint, A. J. (2013). The complex interplay of depression and falls in older adults: a clinical review. American Journal of Geriatric Psychiatry, 21, 484–492.CrossRefGoogle ScholarPubMed
Kanis, J. A. et al. (2005). Smoking and fracture risk: a meta-analysis. Osteoporosis International, 16, 155–162.CrossRefGoogle ScholarPubMed
Kerse, N. et al. (2008). Falls, depression and antidepressants in later life: a large primary care appraisal. PLoS One, 3, e2423.CrossRefGoogle ScholarPubMed
Kizilbash, A. H., Vanderploeg, R. D. and Curtiss, G. (2002). The effects of depression and anxiety on memory performance. Archives of Clinical Neuropsychology, 17, 57–67.CrossRefGoogle ScholarPubMed
Kvaal, K., Mcdougall, F. A., Brayne, C., Matthews, F. E. and Dewey, M. E. (2008). Co-occurrence of anxiety and depressive disorders in a community sample of older people: results from the MRC CFAS (Medical Research Council Cognitive Function and Ageing Study). International Journal of Geriatric Psychiatry, 23, 229–237.CrossRefGoogle Scholar
Lamb, S. E., Jorstad-Stein, E. C., Hauer, K. and Becker, C. (2005). Development of a common outcom data set for fall injury prevention trials: the prevention of falls network Europe consensus. Journal of the American Geriatrics Society, 53, 1618–1622.CrossRefGoogle Scholar
Langlois, F., Vu, T. T., Chasse, K., Dupuis, G., Kergoat, M. J. and Bherer, L. (2013). Benefits of physical exercise training on cognition and quality of life in frail older adults. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 68, 400–404.CrossRefGoogle ScholarPubMed
Launay, C., De Decker, L., Annweiler, C., Kabeshova, A., Fantino, B. and Beauchet, O. (2013). Association of depressive symptoms with recurrent falls: a cross-sectional elderly population based study and a systematic review. The Journal of Nutrition Health and Aging, 17, 152–157.CrossRefGoogle Scholar
Law, M. R. and Hackshaw, A. K. (1997). A meta-analysis of cigarette smoking, bone mineral density and risk of hip fracture: recognition of a major effect. British Medical Journal, 315, 841–846.CrossRefGoogle ScholarPubMed
Laylor, D. A., Patel, R. and Ebrahim, S. (2003). Association between falls in elderly women and chronic diseases and drug use: cross sectional study. British Medical Journal, 327, 712–717.CrossRefGoogle Scholar
Leipzig, R. M., Cumming, R. G. and Tinetti, M. E. (1999). Drugs and falls in older people: a systematic review and meta-analysis: I. Psychotropic drugs. Journal of the American Geriatrics Society, 47, 30–39.CrossRefGoogle ScholarPubMed
Lynn, S. G., Sinaki, M. and Westerlind, K. C. (1997). Balance characteristics of persons with osteoporosis. Archives of Physical Medecine and Rehabilitation, 78, 273–277.CrossRefGoogle ScholarPubMed
Mayne, D., Stout, N. R. and Aspray, T. J. (2010). Diabetes, falls and fractures. Age and Ageing, 39, 522–525.CrossRefGoogle ScholarPubMed
Montorio, I. and Izal, M. (1996). The Geriatric Depression Scale: a review of its development and utility. International Psychogeriatrics, 8, 103–112.CrossRefGoogle Scholar
Muir, S. W., Gopaul, K. and Montero Odasso, M. M. (2012). The role of cognitive impairment in fall risk among older adults: a systematic review and meta-analysis. Age and Ageing, 41, 299–308.CrossRefGoogle ScholarPubMed
Muraki, S. et al. (2013). Physical performance, bone and joint diseases, and incidence of falls in Japanese men and women: a longitudinal cohort study. Osteoporosis International, 24, 459–466.CrossRefGoogle ScholarPubMed
Myers, A. M., Fletcher, P. C., Myers, A. H. and Sherk, W. (1998). Discriminative and evaluative properties of the activities-specific balance confidence (ABC) scale. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 53, M287–M294.CrossRefGoogle ScholarPubMed
Neal, R. M. and Baldwin, R. C. (1994). Screening for anxiety and depression in elderly medical outpatients. Age and Ageing, 23, 461–464.CrossRefGoogle ScholarPubMed
Oosterink, F. M. D., De Jongh, A. and Hoogstraten, J. (2009). Prevalence of dental fear and phobia relative to other fear and phobia subtypes. European Journal of Oral Sciences, 117, 135–143.CrossRefGoogle ScholarPubMed
Pariente, A., Dartigues, J. F., Benichou, J., Letenneur, L., Moore, N. and Fourrier-Réglat, A. (2008). Benzodiazepines and injurious falls in community-dwelling elders. Drugs & Aging, 25, 61–70.CrossRefGoogle ScholarPubMed
Penninx, B. W. J. H., Guralnik, J. M., Ferrucci, L., Simonsick, E. M., Deeg, D. J. H. and Wallace, R. B. (1998). Depressive symptoms and physical decline in community-dwelling older persons. JAMA, 279, 1720–1726.CrossRefGoogle ScholarPubMed
Podsiadlo, D. and Richardson, S. (1991). The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society, 39, 142–148.CrossRefGoogle ScholarPubMed
Reed-Jones, R. J., Solis, G. R., Lawson, K. A., Loya, A. M., Cude-Islas, D. and Berger, C. S. (2013). Vision and falls: a multidisciplinary review of the contributions of visual impairment to falls among older adults. Maturitas, 75, 22–28.CrossRefGoogle Scholar
Roig, M. et al. (2011). Falls in people with chronic obstructive pulmonary disease: an observational cohort study. Respiratory Medicine, 105, 461–469.CrossRefGoogle ScholarPubMed
Rossat, A. et al. (2011). Association between benzodiazepines and recurrent falls: a cross-sectional elderly population-based study. Journal of Nutrition Health and Aging, 15, 72–77.CrossRefGoogle Scholar
Rubenstein, L. Z. and Josephson, K. R. (2002). The epidemiology of falls and syncope. Clinics in Geriatric Medecine, 18, 141–158.CrossRefGoogle ScholarPubMed
Salonen, L. and Kivela, S.-L. (2012). Eye diseases and impaired vision as possible risk factors for recurrent falls in the aged: a systematic review. Current Gerontology and Geriatrics Research, 2012, 10.CrossRefGoogle Scholar
Sinaki, M., Brey, R. H., Hughes, C. A., Larson, D. R. and Kaufman, K. R. (2005). Balance disorder and increased risk of falls in osteoporosis and kyphosis: significance of kyphotic posture and muscle strength. Osteoporosis International, 16, 1004–1010.CrossRefGoogle ScholarPubMed
Smyth, C. A. (2008). Evaluating sleep quality in older adults: The Pittsburgh Sleep Quality Index can be used to detect sleep disturbances or deficits. The American Journal of Nursing, 108, 42–50.CrossRefGoogle ScholarPubMed
Stanmore, E. K. et al. (2013). The Rheumatoid Arthritis and Falls (RAF) study: a prospective study of fall risk factors in adults with rheumatoid arthritis. Lancet, 381, S103.CrossRefGoogle Scholar
Stone, K. L., Ensrud, K. E. and Ancoli-Israel, S. (2008). Sleep, insomnia and falls in elderly patients. Sleep Medicine, 9 (Suppl. 1), S18–22.CrossRefGoogle ScholarPubMed
Stuck, A. E., Walthert, J. M., Nikolaus, T., Bula, C. J., Hohmann, C. and Beck, J. C. (1999). Risk factors for functional status decline in community-living elderly people: a systematic literature review. Social Science & Medicine, 48, 445–469.CrossRefGoogle ScholarPubMed
Tiedemann, A., Sherrington, C. and Lord, S. R. (2005). Physiological and psychological predictors of walking speed in older community-dwelling people. Gerontology, 51, 390–395.CrossRefGoogle ScholarPubMed
Tinetti, M. E., Doucette, J., Claus, E. and Marottoli, R. (1995). Risk factors for serious injury during falls by older persons in the community. Journal of the American Geriatrics Society, 43, 1214–1221.CrossRefGoogle ScholarPubMed
Tinetti, M. E., Speechley, M. and Ginter, S. F. (1988). Risk factors for falls among elderly persons living in the community. New England Journal of Medicine, 319, 1701–1707.CrossRefGoogle ScholarPubMed
Todd, C. and Skelton, D. A. (2004). What are the main risk factors for falls among older people and what are the most effective interventions to prevent falls? Health Evidence Network Report, WHO Regional Office for Europe, Copenhagen, Denmark.Google Scholar
Wechsler, D. (1997). WAIS-III Administration and Scoring Manual. San Antonio, TX: The Psychological Corporation.Google Scholar
Woolcott, J. C. et al. (2009). Meta-analysis of the impact of 9 medication classes on falls in elderly persons. Archives of Internal Medicine, 169, 1952–1960.CrossRefGoogle ScholarPubMed
Yesavage, J. A. (1988). Geriatric Depression Scale. Psychopharmacology Bulletin, 24, 709–711.Google ScholarPubMed
Yesavage, J. A. et al. (1982). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research, 17, 37–49.CrossRefGoogle Scholar