Depression is a common risk factor for falls among older people, and older people who fall are prone to depression. Older people taking SSRIs may be at increased risk. If you are a caregiver of an elderly person, encourage him to exercise regularly to build bone strength and make sure the home is clear of hazardous obstacles.
Risk Factors
Depression and falls are common in older people. Risk factors that increase the chance of experiencing both conditions include poor self-rated health, poor cognitive status, impaired ability to perform activities of daily living, two or more clinic visits in the past month and slow walking speed, found a 2002 study in the "Journal of Epidemiology and Community Health." A. Biderman and colleagues conducted this one-year study with a group of older people who visited a primary care clinic.
Theory
Depression may increase risk of falls in older people because of postural abnormalities, according to a 2004 study in the "International Journal of Experimental, Clinical, Behavioural, Regenerative and Technological Gerontology." Alin Turcu and colleagues conducted a one-year study on patients older than 70 years who were admitted to a geriatric unit for spontaneous unexplained falls. Those who had impaired standing posture were found to be more likely to experience falls.
Effects
Older women with depression are more likely to experience falls, leading to increased risk of fracture, according to a 1999 study in the "Archives of Internal Medicine." Mary A. Whooley and colleagues conducted this study of elderly white women and found that women with depression had a 70 percent chance of experiencing subsequent falls while women without depression had a 59 percent chance. Women with depression had a 40 percent increased rate of nonvertebral fracture compared with women without depression.
Prevention/Solution
Lower leg strengthening and balance retraining can help reduce the likelihood of falls among older people. Home assessment and modification programs can also reduce hazards. If you are a caregiver, make sure the older person's home has appropriate lighting, remove obstacles and install transfer rails to reduce risk of falling. Encourage your loved one to engage regularly in exercise designed to increase muscle and bone strength. Antidepressants can increase risk of falling because they reduce mental alertness, worsen balance and gait and cause drops in systolic blood pressure while standing. Talk with your loved one's doctor about ways to reduce falling risk by using the lowest effective dosage, regularly assessing the requirement for medication and using walking aids.
References
- "International Journal of Experimental, Clinical, Behavioural, Regenerative and Technological Gerontology"; Falls and Depression in Older People; Alin Turcu, Sandrine Toubin, France Mourey et al.; 2004
- "Archives of Internal Medicine"; Depression, Falls, and Risk of Fracture in Older Women; Mary A. Whooley, Kevin E. Kip, Jane A. Cauley et al.; 1999
- PubMed.gov: Depression and Falls Among Community Dwelling Elderly People: a Search for Common Risk Factors.
- Colorado State University Extension: Preventing Falls in the Elderly
