Document Type

Journal Article

Publisher

PLOS

Faculty

Computing, Health and Science

School

Nursing, Midwifery and Postgrad Medicine, Systems and Intervention Research Centre for Health

RAS ID

5569

Comments

This article was originally published as: Kerse, N., Flicker, L., Pfaff, J.J., Draper, B., Lautenschlager, N.T., Sim, M., Snowdon, J., & Almedia, O.P. (2008). Falls, depression and antidepressants in later life: a large primary care appraisal. PLOS One, 3(6), e2423. Original article available here

Abstract

Background: Depression and falls are common and co-exist for older people. Safe management of each of these conditions is important to quality of life.

Methods: A cross-sectional survey was used to examine medication use associated with injurious and non-injurious falls in 21,900 community-dwelling adults, aged 60 years or over from 383 Australian general practices recruited for the DEPS-GP Project. Falls and injury from falls, medication use, depressive symptoms (Primary Health Questionnaire (PHQ-9)), clinical morbidity, suicidal ideation and intent, health status (SF-12 Health Survey), demographic and lifestyle information was reported in a standardised survey.

Findings: Respondents were 71.8 years (sd 7.7) of age and 58.4% were women. 24% 11% and 8% reported falls, fall related injury, and sought medical attention respectively. Antidepressant use (odds ratio, OR: 1.46; 95% confidence interval, 95%CI: 1.25, 1.70), questionable depression (5–14 on PHQ OR: 1.32, 95%CI: 1.13, 1.53) and clinically significant symptoms of depression (15 or more on PHQ OR: 1.70, 95%CI: 1.14, 1.50) were independently associated with multiple falls. SSRI use was associated with the highest risk of multiple falls (OR: 1.66, 95%CI: 1.36, 2.02) amongst all psychotropic medications. Similar associations were observed for injurious falls. Over 60% of those with four accumulated risk factors had multiple falls in the previous year (OR: 3.40, 95%CI: 1.79, 6.45); adjusted for other demographic and health factors.

Interpretation: Antidepressant use (particularly SSRIs) was strongly associated with falls regardless of presence of depressive symptoms. Strategies to prevent falls should become a routine part of the management of older people with depression.

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

 
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Link to publisher version (DOI)

10.1371/journal.pone.0002423