title: Antidepressant Use and Recurrent Falls in Community-Dwelling Older Adults: Findings From the Health ABC Study.
abstract: Few studies have compared the risk of recurrent falls across various antidepressant agents-using detailed dosage and duration data-among community-dwelling older adults, including those who have a history of a fall/fracture.
  
  
  
  To examine the association of antidepressant use with recurrent falls, including among those with a history of falls/fractures, in community-dwelling elders.
  
  
  
  This was a longitudinal analysis of 2948 participants with data collected via interview at year 1 from the Health, Aging and Body Composition study and followed through year 7 (1997-2004). Any antidepressant medication use was self-reported at years 1, 2, 3, 5, and 6 and further categorized as (1) selective serotonin reuptake inhibitors (SSRIs), (2) tricyclic antidepressants, and (3) others. Dosage and duration were examined. The outcome was recurrent falls (≥2) in the ensuing 12-month period following each medication data collection.
  
  
  
  Using multivariable generalized estimating equations models, we observed a 48% greater likelihood of recurrent falls in antidepressant users compared with nonusers (adjusted odds ratio [AOR] = 1.48; 95% CI = 1.12-1.96). Increased likelihood was also found among those taking SSRIs (AOR = 1.62; 95% CI = 1.15-2.28), with short duration of use (AOR = 1.47; 95% CI = 1.04-2.00), and taking moderate dosages (AOR = 1.59; 95% CI = 1.15-2.18), all compared with no antidepressant use. Stratified analysis revealed an increased likelihood among users with a baseline history of falls/fractures compared with nonusers (AOR = 1.83; 95% CI = 1.28-2.63).
  
  
  
  Antidepressant use overall, SSRI use, short duration of use, and moderate dosage were associated with recurrent falls. Those with a history of falls/fractures also had an increased likelihood of recurrent falls.
authors.affiliation: University of Washington, Seattle, WA, USA zmarcum@uw.edu.
authors.forename: Zachary A
authors.initials: ZA
authors.lastname: Marcum
authors.affiliation: University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Subashan
authors.initials: S
authors.lastname: Perera
authors.affiliation: University of Pittsburgh, Pittsburgh, PA, USA VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
authors.forename: Joshua M
authors.initials: JM
authors.lastname: Thorpe
authors.affiliation: University of Pittsburgh, Pittsburgh, PA, USA VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
authors.forename: Galen E
authors.initials: GE
authors.lastname: Switzer
authors.affiliation: University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Nicholas G
authors.initials: NG
authors.lastname: Castle
authors.affiliation: University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Elsa S
authors.initials: ES
authors.lastname: Strotmeyer
authors.affiliation: National Institute on Aging, Baltimore, MD, USA.
authors.forename: Eleanor M
authors.initials: EM
authors.lastname: Simonsick
authors.affiliation: University of California-San Francisco, CA, USA.
authors.forename: Hilsa N
authors.initials: HN
authors.lastname: Ayonayon
authors.affiliation: National Institute on Aging, Baltimore, MD, USA.
authors.forename: Caroline L
authors.initials: CL
authors.lastname: Phillips
authors.affiliation: University of California-San Francisco, CA, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Rubin
authors.affiliation: University of Tennessee Health Sciences Center, Memphis, TN, USA.
authors.forename: Audrey R
authors.initials: AR
authors.lastname: Zucker-Levin
authors.affiliation: University of California-San Francisco, CA, USA.
authors.forename: Douglas C
authors.initials: DC
authors.lastname: Bauer
authors.affiliation: Veterans Affairs Medical Center, Gainesville, FL, USA.
authors.forename: Ronald I
authors.initials: RI
authors.lastname: Shorr
authors.affiliation: University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Yihuang
authors.initials: Y
authors.lastname: Kang
authors.affiliation: University of Washington, Seattle, WA, USA.
authors.forename: Shelly L
authors.initials: SL
authors.lastname: Gray
authors.affiliation: University of Pittsburgh, Pittsburgh, PA, USA VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
authors.forename: Joseph T
authors.initials: JT
authors.lastname: Hanlon
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000187:drug effects; D000928:Antidepressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004363:Drug Utilization; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D012008:Recurrence; D012306:Risk; D057566:Self Report; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D014481:United States
chemical_list: D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors
keywords: aging; antidepressants; drug-related problems; epidemiology; geriatrics; outcomes research/analysis; pharmacoepidemiology