title: Psychiatric disorders, psychotropic medication use and falls among women: an observational study.
abstract: BACKGROUND
  Psychotropic agents known to cause sedation are associated with an increased risk of falls, but the role of psychiatric illness as an independent risk factor for falls is not clear. Thus, this study aimed to investigate the association between psychiatric disorders, psychotropic medication use and falls risk.
  
  
  METHODS
  This study examined data collected from 1062 women aged 20-93 yr (median 50 yr) participating in the Geelong Osteoporosis Study, a large, ongoing, population-based study. Depressive and anxiety disorders for the preceding 12-month period were ascertained by clinical interview. Current medication use and falls history were self-reported. Participants were classified as fallers if they had fallen to the ground at least twice during the same 12-month period. Anthropometry, demographic, medical and lifestyle factors were determined. Logistic regression was used to test the associations, after adjusting for potential confounders.
  
  
  RESULTS
  Fifty-six women (5.3%) were classified as fallers. Those meeting criteria for depression within the past 12 months had a 2.4-fold increased odds of falling (unadjusted OR = 2.4, 95% CI 1.2-4.5). Adjustment for age and mobility strengthened the relationship (adjusted OR = 2.7, 95% CI 1.4-5.2) between depression and falling, with results remaining unchanged following further adjustment for psychotropic medication use (adjusted OR = 2.7, 95% CI 1.3-5.6). In contrast, past (prior to 12-month) depression were not associated with falls. No association was observed between anxiety and falls risk. Falling was associated with psychotropic medication use (unadjusted OR = 2.8, 95% CI 1.5-5.2), as well as antidepressant (unadjusted OR = 2.4, 95% CI 1.2-4.8) and benzodiazepine use (unadjusted OR = 3.4, 95% CI 1.6-7.3); associations remained unchanged following adjustment for potential confounders.
  
  
  CONCLUSIONS
  The likelihood of falls was increased among those with depression within the past 12 months, independent of psychotropic medication use and other recognised confounders, suggesting an independent effect of depression on falls risk. Psychotropic drug use was also confirmed as an independent risk factor for falls, but anxiety disorders were not. Further research into the underlying mechanisms is warranted.
authors.affiliation: IMPACT Strategic Research Centre, School of Medicine, Deakin University, Barwon Health, PO Box 281 (Barwon Health), Geelong, 3220, Australia. lanaw@barwonhealth.org.au.
authors.forename: Lana J
authors.initials: LJ
authors.lastname: Williams
authors.affiliation: IMPACT Strategic Research Centre, School of Medicine, Deakin University, Barwon Health, PO Box 281 (Barwon Health), Geelong, 3220, Australia. juliep@barwonhealth.org.au.|NorthWest Academic Centre, Department of Medicine, The University of Melbourne, Western Health, St Albans, Australia. juliep@barwonhealth.org.au.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Pasco
authors.affiliation: IMPACT Strategic Research Centre, School of Medicine, Deakin University, Barwon Health, PO Box 281 (Barwon Health), Geelong, 3220, Australia. amandh@barwonhealth.org.au.
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Stuart
authors.affiliation: IMPACT Strategic Research Centre, School of Medicine, Deakin University, Barwon Health, PO Box 281 (Barwon Health), Geelong, 3220, Australia. felicejacka@gmail.com.|Department of Psychiatry, The University of Melbourne, Parkville, Australia. felicejacka@gmail.com.
authors.forename: Felice N
authors.initials: FN
authors.lastname: Jacka
authors.affiliation: IMPACT Strategic Research Centre, School of Medicine, Deakin University, Barwon Health, PO Box 281 (Barwon Health), Geelong, 3220, Australia. sharob@barwonhealth.org.au.|NorthWest Academic Centre, Department of Medicine, The University of Melbourne, Western Health, St Albans, Australia. sharob@barwonhealth.org.au.|Australian Institute for Musculoskeletal Sciences, Melbourne, Australia. sharob@barwonhealth.org.au.
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Brennan
authors.affiliation: IMPACT Strategic Research Centre, School of Medicine, Deakin University, Barwon Health, PO Box 281 (Barwon Health), Geelong, 3220, Australia. amelia.dobbins@barwonhealth.org.au.
authors.forename: Amelia G
authors.initials: AG
authors.lastname: Dobbins
authors.affiliation: Bone and Cartilage Research Unit, Surgery, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland. risto.honkanen@fimnet.fi.|Institute of Clinical Medicine, Psychiatry, University of Eastern Finland, Joensuu, Finland. risto.honkanen@fimnet.fi.
authors.forename: Risto
authors.initials: R
authors.lastname: Honkanen
authors.affiliation: Institute of Clinical Medicine, Psychiatry, University of Eastern Finland, Joensuu, Finland. heli.koivumaa@kuh.fi.|Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland. heli.koivumaa@kuh.fi.|Department of Psychiatry, South-Savonia Hospital District, Mikkeli, Finland. heli.koivumaa@kuh.fi.|Department of Psychiatry, North Karelia Central Hospital, Joensuu, Finland. heli.koivumaa@kuh.fi.|Department of Psychiatry, SOSTERI, Savonlinna, Finland. heli.koivumaa@kuh.fi.|Department of Psychiatry, SOTE, Iisalmi, Finland. heli.koivumaa@kuh.fi.|Department of Psychiatry, Lapland Hospital District, Rovaniemi, Finland. heli.koivumaa@kuh.fi.
authors.forename: Heli
authors.initials: H
authors.lastname: Koivumaa-Honkanen
authors.affiliation: Bone and Cartilage Research Unit, Surgery, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland. pr.rauma@gmail.com.|Department of Social Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Finland, Finland. pr.rauma@gmail.com.
authors.forename: Päivi H
authors.initials: PH
authors.lastname: Rauma
authors.affiliation: IMPACT Strategic Research Centre, School of Medicine, Deakin University, Barwon Health, PO Box 281 (Barwon Health), Geelong, 3220, Australia. mikebe@barwonhealth.org.au.|Department of Psychiatry, The University of Melbourne, Parkville, Australia. mikebe@barwonhealth.org.au.|The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Australia. mikebe@barwonhealth.org.au.|Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Parkville, Australia. mikebe@barwonhealth.org.au.
authors.forename: Michael
authors.initials: M
authors.lastname: Berk
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000188:drug therapy*; D001569:Benzodiazepines / Q000627:therapeutic use; D003866:Depressive Disorder / Q000188:drug therapy*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D011619:Psychotropic Drugs / Q000009:adverse effects*; D012307:Risk Factors; D055815:Young Adult
chemical_list: D011619:Psychotropic Drugs; D001569:Benzodiazepines