title: Depressive Symptoms and Orthostatic Hypotension Are Risk Factors for Unexplained Falls in Community-Living Older People.
abstract: To investigate risk factors for unexplained falls in older community-dwelling individuals.
  
  
  
  Prospective cohort study.
  
  
  
  Community population, Sydney, Australia.
  
  
  
  Older adults (N = 529; mean age 79.8 ± 4.4, 52.2% female).
  
  
  
  Participants provided information demographic, medical, and medication characteristics and completed cardiovascular (tilt table test, pulse wave velocity), cognitive, and sensorimotor assessments at baseline. Falls were then recorded in monthly fall diaries for 12 months. Unexplained fallers (UFs) were those who reported falls due to a blackout, dizziness, feeling faint, or "found themselves suddenly on the ground."
  
  
  
  Of the 523 participants available at follow-up, 238 (45.5%) reported one or more falls; 35 participants fulfilled the definition of UFs. UFs were more likely than balance-related fallers (BFs) (n = 203) and nonfallers (n = 291) to have orthostatic hypotension (39.4%, 20.5% and 22.4%, respectively) and depressive symptoms (24.2%, 10.1%, and 7.9% respectively). More UFs (88.6%) than BFs (70.9%) had injurious falls. A multivariate logistic regression model revealed that depressive symptoms and orthostatic hypotension were significant and independent determinants of UF status.
  
  
  
  Approximately 15% of fallers had unexplained falls, which were more likely to result in injuries. Depressive symptoms and orthostatic hypotension increased the risk of unexplained falls, whereas cognitive deficits and sensorimotor and balance impairments did not. Future research should investigate whether psychotherapy and physical exercise to improve mood and medication reviews and nonpharmacological therapies for the treatment of orthostatic hypotension and depression are effective at reducing the risk of unexplained falls in older people.
authors.affiliation: Neuroscience Research Australia, University of New South Wales, Sydney, Australia.|School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
authors.forename: Jasmine C
authors.initials: JC
authors.lastname: Menant
authors.affiliation: Neuroscience Research Australia, University of New South Wales, Sydney, Australia.
authors.forename: Alfred K W
authors.initials: AK
authors.lastname: Wong
authors.affiliation: Department of Developmental Disability Neuropsychiatry, University of New South Wales, Sydney, Australia.|Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia.
authors.forename: Julian N
authors.initials: JN
authors.lastname: Trollor
authors.affiliation: Neuroscience Research Australia, University of New South Wales, Sydney, Australia.|Prince of Wales Clinical School, University of New South Wales, Sydney, Australia.
authors.forename: Jacqueline C T
authors.initials: JC
authors.lastname: Close
authors.affiliation: Neuroscience Research Australia, University of New South Wales, Sydney, Australia.|School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Lord
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D003863:Depression / Q000150:complications*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007024:Hypotension, Orthostatic / Q000150:complications*; D057187:Independent Living; D008297:Male; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D012307:Risk Factors; D018667:Tilt-Table Test
keywords: accidental falls; aged; depression; orthostatic hypotension; unexplained falls