Depression as a predictor of falls amongst institutionalized elders

Abstract

Objective: In this study, we set out to examine the combined effects of medical condition and depression status on fall incidents amongst institutionalized elderly people.

Methods: A cross-sectional study was carried out to investigate the fall history of institutionalized elders involving 286 subjects. Experiences of falls over the previous year were recorded, with at least two falls during the prior one-year period, or one injurious fall 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 have enhanced effects with various medical conditions on fall risk. As compared with the non-depressive reference group, a five-fold fall risk was discernible amongst depressed elders with multiple medications, whilst a six-fold risk was found amongst depressive elders using ancillary devices, along with a 11-fold amongst depressive elders with neural system diseases.

Conclusions: This study provides the evidence of enhancing effects between depression and medical conditions on the risk of falls amongst institutionalized elderly people. Thus, depressed elders with neural system diseases, using ancillary devices or multiple medications, should be specifically listed as very high risk of falling amongst institutionalized elderly, and strictly prevent them from falls. Screening and treatment of depression could also be a useful strategy in the prevention of falls amongst institutionalized elderly with poor medical condition.

Keywords:

• depression
• predictor of falls
• institutionalized elders

Acknowledgments

We gratefully acknowledge the financial support provided for this research by the National Science Council of the Executive Yuan, Republic of China, Taiwan (Grant No.: NSC97-2314-B-016-035-MY3). We also gratefully acknowledge the contributions of each of the numerous colleagues who have participated in this study.