title: Depression and risk for adverse falls in older home health care patients.
abstract: Because falls are highly prevalent, harmful events for older adults, identification of patients at risk is a high priority for home health care agencies. Using routine administrative data, we demonstrated that patients with depressive symptoms on the Outcome and Assessment Information Set are at risk for falls. A prospective case-control study that matched 54 patients who experienced an adverse fall with 854 controls showed that patients who fell had twice the odds of being depressed (odds ratio = 1.90, 95% confidence interval = 1.01 to 3.59). Bowel incontinence, high medical comorbidity, stair use, injury and poisoning, memory deficit, and antipsychotic medication use were also predictors, but no association was found for antidepressant medications. These data suggest the potential benefit of including depression screening for multifactorial fall prevention interventions.
authors.affiliation: Department of Psychiatry, Weill-Cornell Institute of Geriatric Psychiatry, Weill Cornell Medical College, White Plains, New York 10605, USA. alb2018@med.cornell.edu
authors.forename: Amy L
authors.initials: AL
authors.lastname: Byers
authors.forename: Thomas
authors.initials: T
authors.lastname: Sheeran
authors.forename: Amy E
authors.initials: AE
authors.lastname: Mlodzianowski
authors.forename: Barnett S
authors.initials: BS
authors.lastname: Meyers
authors.forename: Pamella
authors.initials: P
authors.lastname: Nassisi
authors.forename: Martha L
authors.initials: ML
authors.lastname: Bruce
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D016022:Case-Control Studies; D015897:Comorbidity; D003863:Depression / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D015577:Geriatric Assessment; D006699:Home Care Services / Q000458:organization & administration; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D009730:Nursing Assessment; D015399:Nursing Research; D017063:Outcome Assessment, Health Care; D016016:Proportional Hazards Models; D011446:Prospective Studies; D019984:Quality Indicators, Health Care; D018570:Risk Assessment; D012307:Risk Factors