Interactive effect between depression and chronic medical conditions on fall risk in community-dwelling elders.
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.
School of Public Health, National Defense Medical Center, Taipei, Taiwan.
Senyeong
S
Kao
Yun-Chang
YC
Wang
Ya-Mei
YM
Tzeng
Chang-Kuo
CK
Liang
Fu-Gong
FG
Lin
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000523:psychology; D002908:Chronic Disease / Q000453:epidemiology* / Q000523:psychology; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000523:psychology; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology