Depression and Outcome of Fear of Falling in a Falls Prevention Program.
OBJECTIVE
To examine whether depression predicts less improvement in fear of falling and falls efficacy in older adults attending a falls prevention program (FPP).


METHODS
Using a prospective observational design in an academic medical center, the authors studied 69 nondemented adults aged 55 years or older (mean age: 77.8±8.9 years) who had experienced at least one fall in the previous year and who attended the FPP. The primary outcome variable was change in severity of fear of falling during the FPP. Secondary outcome variables were change in falls efficacy and fear-related restriction of activities during the FPP. Independent variables were baseline depressive disorders and depressive symptom severity.


RESULTS
Twenty-one of 69 study participants (30.4%) had a depressive disorder at baseline. Depressive disorder and depressive symptoms were not associated with change in severity of fear of falling or restriction of activity. On the other hand, depressive disorder was associated with improvement in falls efficacy, although this finding was not significant in multivariate analysis. Among participants with a depressive disorder, improvement in falls efficacy was significantly correlated with improvement in depressive symptoms.


CONCLUSIONS
There was no association between baseline depression and change in fear of falling in this FPP. The correlation between improvement in depressive symptoms and improvement in falls efficacy raises the question as to whether a cognitive-behavioral intervention that simultaneously targets both depression and falls efficacy would be a useful component of a FPP.
Department of Psychiatry, University Health Network and University of Toronto, Toronto, Ontario, Canada.
Andrea
A
Iaboni
Falls Prevention Program, University Health Network, Toronto, Ontario, Canada.
Carol
C
Banez
Department of Family and Community Medicine, University Health Network and University of Toronto, Toronto, Ontario, Canada.
Robert
R
Lam
Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada.
Simon A
SA
Jones
Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada; Department of Surgery, Institute of Biomaterials and Biomedical Engineering, and Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.
Brian E
BE
Maki
Regional Geriatric Program of Toronto, Division of Geriatric Medicine, Sunnybrook Health Sciences Centre, and Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Barbara A
BA
Liu
Department of Psychiatry, University Health Network and University of Toronto, Toronto, Ontario, Canada. Electronic address: alastair.flint@uhn.on.ca.
Alastair J
AJ
Flint
D000046:Academic Medical Centers; D000058:Accidental Falls / Q000517:prevention & control*; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000175:diagnosis*; D003866:Depressive Disorder / Q000175:diagnosis*; D005239:Fear; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009864:Ontario; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index
Depression; falls efficacy; fear of falling