Hostname: page-component-8448b6f56d-c4f8m Total loading time: 0 Render date: 2024-04-19T14:38:11.106Z Has data issue: false hasContentIssue false
  • English
  • Français

Interactive effect between depression and chronic medical conditions on fall risk in community-dwelling elders

Published online by Cambridge University Press:  01 May 2012

Senyeong Kao ,
Yun-Chang Wang ,
Ya-Mei Tzeng ,
Chang-Kuo Liang  and
Fu-Gong Lin
Senyeong Kao
Affiliation:
School of Public Health, National Defense Medical Center, Taipei, Taiwan
Yun-Chang Wang
Affiliation:
Institute of Life Science, National Defense Medical Center, Taipei, Taiwan
Ya-Mei Tzeng
Affiliation:
Institute of Life Science, National Defense Medical Center, Taipei, Taiwan
Chang-Kuo Liang
Affiliation:
School of Public Health, National Defense Medical Center, Taipei, Taiwan
Fu-Gong Lin*
Affiliation:
School of Public Health, National Defense Medical Center, Taipei, Taiwan
*
Correspondence should be addressed to: Prof. Fu-Gong Lin, School of Public Health, National Defense Medical Center, No. 161, Min-Chun E. Rd., Sec. 6, Taipei, Taiwan. Phone: +886-2-87923100, ext. 18010; Fax: +886-2-87924811. Email: fugong@mail.ndmctsgh.edu.tw.
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: It is well documented that fall risk among elderly people is associated with poor health and depression. In this study, we set out to examine the combined effects of medical condition and depression status on fall incidents among community-dwelling elderly people.

Methods: A cross-sectional study was carried out to investigate the fall history of community-dwelling elders involving 360 participants. Those who had experienced at least two falls over the previous year, or one injurious fall, were defined as “fallers.” The Geriatric Depression Scale-15 was used as a screening instrument for depression status.

Results: Based on a multivariate logistic regression and stratification analysis, depression was found to interact with various medical conditions on fall risk. In comparison with the non-depressive reference group, a six-fold fall risk was discernible among depressed elders with polypharmacy, while a five-fold risk was found among depressive elders using ancillary devices, along with a four-fold risk among depressive elders with diabetes or cardiovascular disease. Finally, arthritis was found to produce a nine-fold risk of falls among such populations.

Conclusions: These findings suggest that greater emphasis should be placed on the integration of depression screening as an element of fall risk assessment in elderly people.

Keywords

falldepressioninteraction effectmedical condition
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 9 , September 2012 , pp. 1409 - 1418
Copyright
Copyright © International Psychogeriatric Association 2012

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

Andersson, T., Alfredsson, L., Kallberg, H., Zdravkovic, S. and Ahlbom, A. (2005). Calculating measures of biological interaction. European Journal of Epidemiology, 20, 575–579.CrossRefGoogle ScholarPubMed
Byers, A. L., Sheeran, T., Mlodzianowski, A. E., Meyers, B. S., Nassisi, P. and Bruce, M. L. (2008). Depression and risk for adverse falls in older home health care patients. Research in Gerontological Nursing, 1, 245–251.CrossRefGoogle ScholarPubMed
Chang, H. J. et al. (2010). Epidemiological survey of salls and associated risk factors in old females in an aging community. Taiwan Geriatrics & Gerontology, 5, 50–61.Google Scholar
Chang, C. M. et al. (2011). Medical conditions and medications as risk factors of falls in the inpatient older people: a case-control study. International Journal of Geriatric Psychiatry, 26, 602–607. doi: 10.1002/gps.2569.CrossRefGoogle ScholarPubMed
Chin, M. Y., Lu, D. F. and Wu, M. H. (2008). Factors related to falls among the community-dwelling elderly. Hu Li Za Zhi, 55, 39–48.Google ScholarPubMed
Chu, H., Nie, L. and Cole, S. R. (2011). Estimating the relative excess risk due to interaction: a Bayesian approach. Epidemiology, 22, 242–248.CrossRefGoogle ScholarPubMed
Delbaere, K. et al. (2010). A multifactorial approach to understanding fall risk in older people. Journal of the American Geriatrics Society, 58, 1679–1685.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
Frasure-Smith, N. and Lesperance, F. (2008). Depression and anxiety as predictors of 2-year cardiac events in patients with stable coronary artery disease. Archives of General Psychiatry, 65, 62–71.CrossRefGoogle ScholarPubMed
Ganz, D. A., Higashi, T. and Rubenstein, L. Z. (2005). Monitoring falls in cohort studies of community-dwelling older people: effect of the recall interval. Journal of the American Geriatrics Society, 53, 2190–2194.CrossRefGoogle ScholarPubMed
Garber, C. E., Greaney, M. L., Riebe, D., Nigg, C. R., Burbank, P. A. and Clark, P. G. (2010). Physical and mental health-related correlates of physical function in community dwelling older adults: a cross sectional study. BMC Geriatrics, 10, 6.CrossRefGoogle ScholarPubMed
Golden, S. H. et al. (2008). Examining a bidirectional association between depressive symptoms and diabetes. JAMA, 299, 2751–2759.CrossRefGoogle ScholarPubMed
Gruber-Baldini, A. L., Zimmerman, S., Boustani, M., Watson, L. C., Williams, C. S. and Reed, P. S. (2005). Characteristics associated with depression in long-term care residents with dementia. Gerontologist, 45, 50–55.CrossRefGoogle ScholarPubMed
Huang, S.-C., Chen, T.-J. and Chou, P. (2005). Culmulative incident rate and associated factors of falls among the elderly in Shih-Pai. Taiwan Journal of Public Health, 24, 136–145.Google Scholar
Kerse, N. et al. (2008). Falls, depression and antidepressants in later life: a large primary care appraisal. PLoS One, 18, 3, e2423.CrossRefGoogle Scholar
Kose, N., Cuvalci, S., Ekici, G., Otman, A. S. and Karakaya, M. G. (2005). The risk factors of fall and their correlation with balance, depression, cognitive impairment and mobility skills in elderly nursing home residents. Saudi Medical Journal, 26, 978–981.Google ScholarPubMed
Kwan, M. M., Close, J. C., Wong, A. K. and Lord, S. R. (2011). Falls incidence, risk factors, and consequences in chinese older people: a systematic review. Journal of the American Geriatrics Society, 59, 536–543.CrossRefGoogle ScholarPubMed
Lin, M. R. and Wang, Y. W. (2004). Risk factors and prevention of falls among community-dwelling older people. Taiwan Journal of Public Health, 23, 259–271.Google Scholar
Lin, M. R., Tsai, S. L., Chen, S. Y. and Tzeng, S. J. (2002). Risk factors for elderly falls in a rural community of central Taiwan. Taiwan Journal of Public Health, 21, 73–82.Google Scholar
Liu, C. Y. et al. (1997). Depressive disorders among older residents in a Chinese rural community. Psychological Medicine, 27, 943–949.CrossRefGoogle Scholar
Pan, A. et al. (2010). Bidirectional association between depression and type 2 diabetes mellitus in women. Archives of Internal Medicine, 170, 1884–1891.CrossRefGoogle ScholarPubMed
Penninx, B. W. et al. (2001). Depression and cardiac mortality: results from a community-based longitudinal study. Archives of General Psychiatry, 58, 221–227.CrossRefGoogle ScholarPubMed
Rubenstein, L. Z. and Josephson, K. R. (2002). The epidemiology of falls and syncope. Clinics in Geriatric Medicine, 18, 141–158.CrossRefGoogle ScholarPubMed
Tinetti, M. E. and Speechley, M. (1989). Prevention of falls among the elderly. The New England Journal of Medicine, 320, 1055–1059.Google ScholarPubMed
Tinetti, M. E., Richman, D. and Powell, L. (1990). Falls efficacy as a measure of fear of falling. Journal of Gerontology: Psychological Sciences, 45, 239–243.CrossRefGoogle ScholarPubMed
Tong, H. M., Lai, D. W., Zeng, Q. and Xu, W. Y. (2011). Effects of social exclusion on depressive symptoms: elderly Chinese living alone in Shanghai, China. Journal of Cross-Cultural Gerontology, 26, 349–364.CrossRefGoogle ScholarPubMed
Turcu, A., Toubin, S., Mourey, F., D'Athis, P., Manckoundia, P. and Pfitzenmeyer, P. (2004). Falls and depression in older people. Gerontology, 50, 303–308.CrossRefGoogle ScholarPubMed
Yu, E. S. et al. (1989). Cognitive impairment among elderly adults in Shanghai, China. The Journals of Gerontology, 44, S97–S106.CrossRefGoogle ScholarPubMed
Yu, P. L. et al. (2009). Prevalence and related factors of falls among the elderly in an urban community of Beijing. Biomedical and Environmental Sciences, 22, 179–187.CrossRefGoogle Scholar