Document Type

Journal Article

Publisher

PLOS

Faculty

Faculty of Computing, Health and Science

School

School of Nursing, Midwifery and Postgraduate 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.

DOI

10.1371/journal.pone.0002423

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