Depression often a precursor to falls in elderly people
Depression affects about 350 million people worldwide resulting in altered appetite, inconsistent sleeping patterns, loss of interest in everyday activities, a low mood, increased anxiety – and it also raises the risk of falls.
The findings were published recently in the journal Social Science & Medicine.
Health and Retirement Study
"Many interventions to prevent falls are expensive and time-intensive, but this is a simple and inexpensive matter of encouraging continued use of psychiatric medication while improving monitoring of fall risk and adjusting medication appropriately," said lead researcher Geoffrey Hoffman. He is a research fellow and an assistant professor of nursing at the University of Michigan's School of Nursing.
A WHO (World Health Organization) Global Report on Falls among Older Persons reported, “Apart from South Africa, no other African countries provide guidelines for the management and prevention of falls in the elderly."
To examine the link between depression and fall risk, Hoffman's team looked at falls involving more than 7 200 people 65 and older who were part of the National Health and Retirement Study between 2006 and 2010.
The South African Medical Journal (SAMJ) promotes the examination of history of falls to include the frequency of falls, environmental factors such as time, location, floor surface, lighting, obstacles and precipitants, as well as associated factors such as footwear, use of walking aids, glasses, and substances or medications.
This determines whether causative factors or contributory factors are responsible for the increased risk of falls in the elderly.
A moderate rise in symptoms of depression among older people was linked with a 30% increase in falling within two years. But when the researchers added medication use into the mix, the strength of the association between depressive symptoms and falls dropped to insignificant levels.
Role of psychiatric medication
According to Health24, in order to diagnose someone with depression, at least one of the nine symptoms – set down in the DSM–V (Diagnostic and Statistical Manual of Mental Disorder, 5th edition) to diagnose a Major Depressive Episode – has to be "depressed mood" or "loss of interest or pleasure".
Hoffman cautioned that doctors and older patients should still weigh the risks and benefits of psychiatric medication.
And physicians should be particularly careful when prescribing and dosing certain medications such as tranquilizers, antidepressants and anxiety drugs for their older patients.
Falls among the elderly cost about $30 billion a year in the United States, and up to half of nursing home admissions follow a fall, the researchers noted. About one-third of Americans 65 or older fall each year, and about 10% of all elderly people are injured during falls.
But falls in the elderly are avoidable with the correct treatment (both before and after a fall), awareness of the impact falling has, as well as the risk factors and how to manage it.