title: Falls in older adults with major depressive disorder (MDD): a systematic review and exploratory meta-analysis of prospective studies.
abstract: BACKGROUND
  Depressive symptomology is now widely recognized as a key risk factor for falls. The evidence regarding the impact of major depressive disorder (MDD) on falls is unclear. A systematic review and exploratory meta-analysis was undertaken to explore the relationship between MDD and falls.
  
  
  METHODS
  Major electronic database were searched from inception till April 2015. Studies that defined MDD and measured falls prospectively in older adults (≥60 years) were included. Studies relying on depressive symptomology alone were excluded. The methodological quality of included articles was assessed and study findings were synthesized using an exploratory meta-analysis.
  
  
  RESULTS
  From a potential of 415 articles, only three studies met the inclusion criteria. This included 976 unique older adults with a range of mean age from ≥65 to 83 years. The methodological quality of included studies was satisfactory. None of the included studies' primary aim was to investigate the relationship between MDD and falls. The exploratory meta-analysis demonstrated older adults with MDD are at increased risk of falling compared to non-depressed older adults (odds ratio (OR) 4.0, 95% CI 2.0-8.1, I(2) = 60%, n = 976).
  
  
  CONCLUSIONS
  There is a paucity of research considering falls in older adults with MDD. Our results demonstrate that the odds of falling appear to be greater among people with MDD (OR 4.0) than in previous meta-analyses that have only considered subthreshold depressive symptoms. Given the distinct nature and challenges with MDD, more research is required to better understand the falls risk in this group.
authors.affiliation: Health Service and Population Research Department,Institute of Psychiatry,King's College London,De Crespigny Park,London,Box SE5 8AF,UK.
authors.forename: Brendon
authors.initials: B
authors.lastname: Stubbs
authors.affiliation: Research Associate,St Andrews Healthcare,Northampton,NN1 5DG,UK.
authors.forename: Jean
authors.initials: J
authors.lastname: Stubbs
authors.affiliation: Physiotherapy department,South London and Maudsley NHS Foundation Trust,Denmark Hill,London,UK.
authors.forename: Solomon Donald
authors.initials: SD
authors.lastname: Gnanaraj
authors.affiliation: Department of Physiotherapy,School of Sport,Exercise and Rehabilitation Sciences,University of Birmingham,Birmingham,B15 2TT,UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Soundy
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D003863:Depression / Q000150:complications*; D003865:Major Depressive Disorder / Q000150:complications*; D006801:Humans; D011446:Prospective Studies; D012307:Risk Factors
keywords: falls; major depression; major depressive disorder