Association Between Depressive Symptoms and Physiological Risk Factors for Falls

Objective: To investigate the association between depressive symptoms and falls in community-dwelling older adults.

Methods: This is a cross-sectional study with 278 participants aged 60 or older. Information on clinical and sociodemographic data were obtained from a structured interview, depressive symptoms were assessed with the Geriatric Depression Scale (GDS), falls in the previous year were self-reported, and risk of falls was assessed with the Physiological Profile Assessment (PPA). Fallers and nonfallers were compared with Mann-Whitney and chi-squared tests. A binary logistic model was used to investigate the association between falls and GDS score, followed by a binomial negative regression model to analyze the association of GDS score and the number of falls. Finally, groups of individuals screened positive or negative for depression were compared for risk of falls and each individual's PPA test.

Discussion: Fallers presented more chronic conditions, polypharmacy, worse subjective health status and higher GDS scores. Individuals with higher GDS scores presented a higher chance of falling. The number of falls was not associated to the GDS score; however, there was an association between falls and the number of morbidities. Positive screening for depression was associated to a higher risk of falls according to the PPA, as well as to reaction time.

Conclusion: Fallers presented more depressive symptoms, morbidities, polypharmacy, and worse subjective health status. Depressive symptoms do not act directly over the number of falls; nonetheless, those with depressive symptoms presented a higher chance of falling, which may be associated to slower reaction time. Psychological symptoms play an important role in falls, and should, therefore, be considered in identifying older people at risk and in developing prevention programs.