Skip to main content
SpringerLink
Log in

Association of depressive symptoms with recurrent falls: A cross-sectional elderly population based study and a systematic review

  • Published:
The journal of nutrition, health & aging

Abstract

Background

Screening of depressive symptoms is recommended in recurrent fallers. Compared to the 30-item and 15-item Geriatric Depression Scales (GDS), the 4-item GDS is easier to administer and quicker to perform. The association between abnormal 4-item GDS score and recurrent falls has not yet been examined, hi addition, while depressive symptoms-related gait instability is well known, the association with recurrent falls has been few studied.

Objective

1) To examine the association between abnormal 4-item GDS score and recurrent falls in community-dwelling older adults using original data from health examination centers (HEC) of French health insurance of Lyon, and 2) to perform a systematic review of studies that examined the association of depressive symptoms with recurrent falls among older adults.

Methods

Firstly, based on a cross-sectional design, 2,594 community-dwellers (mean age 72.1±54years; 49.8% women) were recruited in HEC of Lyon, France. The 4-item GDS score (abnormal if score>l) and recurrent falls (i.e., 2 or more falls in the past year) were used as main outcomes. Secondly, a systematic English and French Medline literature search was conducted on May 28, 2012 with no limit of date using the following Medical Subject Heading (MeSH) terms “Aged OR aged, 80 and over”, “Accidental falls”, “Depressive disorder” and “Reccurence”. The search also included the reference lists of the retrieved articles.

Results

A total of 19.0% (n=494) participants were recurrent fallers in the cross-sectional study. Abnormal 4-item GDS score was more prevalent among recurrent fallers compared to non-recurrent fallers (44.7% versus 25.0%, with P<0.001), and was significantly associated with recurrent falls (Odd ratio (OR)=1.82 with P<0.001 for full model; OR=1.86 with P<0.001 for stepwise backward model). In addition to the current study, the systematic review found only four other studies on this topic, three of them examining the association of depressive symptoms with recurrent falls using 30-item or 15-item GDS. All studies showed a significant association of depressive symptoms with recurrent falls.

Conclusions

The current cross-sectional study shows an association between abnormal 4-item GDS score and recurrent falls. This association of depressive symptoms with recurrent falls was confirmed by the systematic review. Based on these results, we suggest that recurrent falls risk assessment should involve a systematic screening of depressive symptoms using the 4-item GDS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Whooley MA, Kip KE, Cauley JA, Ensrud KE, Nevitt MC, Browner WS. Depression, falls, and risk of fracture in older women. Study of Osteoporotic Fractures Research Group. Arch Intern Med. 1999;159:48–490.

    Article  Google Scholar 

  2. Alexander NB. Gait disorders in older adults. J Am Geriatr Soc. 1996;44:434–451.

    PubMed  CAS  Google Scholar 

  3. Hausdorff JM, Nelson ME, Kaliton D, Layne JE, Bernstein MI, Nuernberger A, Singh MA. Etiology and modification of gait instability in older adults: a randomized controlled trial of exercise. J Appl Physiol. 2001;90:2117–2129.

    PubMed  CAS  Google Scholar 

  4. Somadder M, Mondai S, Kersh R, Abdelhafiz AH. Are recurrent fallers depressed? J Am Geriatr Soc. 2007;55:2097–2099.

    Article  PubMed  Google Scholar 

  5. Wada T, Ishine M, Ishimoto Y, Hirosaki M, Kimura Y, Kasahara Y, Okumiya K, Nishinaga M, Otsuka K, Matsubayashi K. Community-dwelling elderly fallers in Japan are older, more disabled, and more depressed than nonfallers. J Am Geriatr Soc. 2008;56:1570–1571.

    Article  PubMed  Google Scholar 

  6. Stel VS, Pluijm SM, Deeg DJ, Smit JH, Bouter LM, Lips P. A classification tree for predicting recurrent falling in community-dwelling older persons. J Am Geriatr Soc. 2003;51:1356–1364.

    Article  PubMed  Google Scholar 

  7. Beauchet O, Dubost V, Revel Delhom C, Berrut G, Belmin I; French Society of Geriatrics and Gerontology. How to manage recurrent falls in clinical practice: guidelines of the French Society of Geriatrics and Gerontology. J Nutr Health Aging. 2011;15:79–84.

    Article  PubMed  Google Scholar 

  8. de Decker L, Annweiler C, Yvain F, Leroux P, Lermite P, Berrut G, Hily S, Beauchet O. How to manage gait and balance disorders among older adults aged 65 years and older with mild to moderate dementia in clinical practice? Geriatr Psychol Neuropsychiatr Vieil. 2011;9:269–276.

    PubMed  Google Scholar 

  9. Kessler D, Lloyd K, Lewis G, Gray DP. Cross sectional study of symptom attribution and recognition of depression and anxiety in primary care. BMI. 1999;318:436–439.

    Article  CAS  Google Scholar 

  10. Shah A, Herbert R, Lewis S, Mahendran R, Piatt I, Bhattacharyya B. Screening for depression among acutely ill geriatric inpatients with a short Geriatric Depression Scale. Age Ageing. 1997;26:217–221

    Article  PubMed  CAS  Google Scholar 

  11. Lord SR, Ward IA, Williams P et al. Physiological factors associated with falls in older community-dwelling women. J Am Geriatr Soc 1994;42:1110–1117.

    PubMed  CAS  Google Scholar 

  12. Cahn DA, Salmon DP, Monsch AU, Butters N, Wiederholt WC, Corey-Bloom I, Barrett-Connor E. Screening for dementia of the alzheimer type in the community: the utility of the Clock Drawing Test. Arch Clin Neuropsychol. 1996;11:529–539.

    PubMed  CAS  Google Scholar 

  13. Anstey KI, Burns R, von Sanden C, Luszcz MA. Psychological well-being is an independent predictor of falling in an 8-year follow-up of older adults. J Gerontol B Psychol Sei Soc Sci. 2008;63:P249–P257.

    Article  Google Scholar 

  14. Biderman A, Cwikel I, Fried AV, Galinsky D. Depression and falls among community dwelling elderly people: a search for common risk factors. J Epidemiol Community Health. 2002;56:631–636.

    Article  PubMed  CAS  Google Scholar 

  15. Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing. 2006;35Suppl 2:ii37–ii41.

    Article  PubMed  Google Scholar 

  16. Tinetti M. Preventing falls in elderly persons. N Engl J Med. 2003;348:42–49.

    Article  PubMed  Google Scholar 

  17. Lipsitz LA, Lonsson PV, Kelley MM, Koestner IS. Causes and correlates of recurrent falls in ambulatory frail elderly. J Gerontol. 1991;46:M114–M122.

    Article  PubMed  CAS  Google Scholar 

  18. American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopedic Surgeons panel on falls prevention. Guideline for the prevention of falls in older persons. J Am Geriatr Soc 2001;49: 664–772.

    Article  Google Scholar 

  19. Ostir GV, Markides KS, Black SA, Goodwin IS. Emotional well-being predicts subsequent functional independence and survival. J Am Geriatr Soc. 2000;48:473–478.

    PubMed  CAS  Google Scholar 

  20. Penninx BW. A happy person, a healthy person? J Am Geriatr Soc. 2000;48:590–592.

    PubMed  CAS  Google Scholar 

  21. Alexander GE, Crutcher MD. Functional architecture of basal ganglia circuits: neural substrates of parallel processing. Trends Neurosci. 1990;13:266–271.

    Article  PubMed  CAS  Google Scholar 

  22. Wu Q, Liu J, Gallegos-Orozco JF, Hentz JG. Depression, fracture risk, and bone loss: a meta-analysis of cohort studies. Osteoporos Int. 2010;21:1627–1635.

    Article  PubMed  CAS  Google Scholar 

  23. Mezuk B, Eaton WW, Golden SH. Depression and osteoporosis: epidemiology and potential mediating pathways. Osteoporos Int. 2008;19:1–12.

    Article  PubMed  CAS  Google Scholar 

  24. Poujol L, Annweiler C, Allali G, Fantino B, Beauchet O. Effect of psychoactive medication on gait variability in community-dwelling older adults: a cross-sectional study. J Am Geriatr Soc. 2010;58:1207–1208.

    Article  PubMed  Google Scholar 

  25. Beauchet O, Allali G, Annweiler C, Bridenbaugh S, Assal F, Kressig RW, Herrmann FR. Gait variability among healthy adults: low and high stride-to-stride variability are both a reflection of gait stability. Gerontology. 2009;55:702–706.

    Article  PubMed  Google Scholar 

  26. Rossat A, Fantino B, Nitenberg C, Annweiler C, Poujol L, Herrmann FR, Beauchet O. Risk factors for falling in community-dwelling older adults: which of them are associated with the recurrence of falls? J Nutr Health Aging. 2010; 14:787–791.

    Article  PubMed  CAS  Google Scholar 

  27. Oliver D, Britton M, Seed P, Martin FC, Hopper AH. Development and evaluation of evidence based risk assessment tool (STRATIFY) to predict which elderly inpatients will fall: case-control and cohort studies. BMI. 1997;315:1049–1053

    Article  CAS  Google Scholar 

  28. Bloem BR, Steijns IA, Smits-Engelsman BC. An update on falls. Curr Opin Neurol 2003;16:15–26.

    Article  PubMed  Google Scholar 

  29. Hsiao ET, Robinoviteh SN. Common protective movements govern unexpected falls from standing height. J Biomech 1998;31:1–9

    Article  PubMed  CAS  Google Scholar 

  30. Pai YC, Wening JD, Runtz EF, Pavol MI. Role of feed forward control of movement stability in reducing slip-related balance loss and falls among older adults. J Neurophysiol 2003;90:755–762.

    Article  PubMed  Google Scholar 

  31. Cummings SR, Nevitt MC, Kidd S. Forgetting falls. The limited accuracy of recall of falls in the elderly. J Am Geriatr Soc 1988;36: 613–616.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neuroscience, Division of Geriatric Medicine, Angers University Hospital, Angers, France

    C. Launay, C. Annweiler, A. Kabeshova, B. Fantino & Olivier Beauchet

  2. Angers University Memory Clinic, Angers, France

    C. Launay, C. Annweiler, A. Kabeshova, B. Fantino & Olivier Beauchet

  3. Department of Geriatrics, Nantes University Hospital, Nantes, France

    L. De Decker

  4. UPRES EA 2646, University of Angers, UNAM, Angers, France

    C. Annweiler & Olivier Beauchet

  5. Department of Neuroscience, Division of Geriatric Medicine, Angers University Hospital, 49933, Angers Cedex 9, France

    Olivier Beauchet

Authors
  1. C. Launay
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. L. De Decker
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. Annweiler
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Kabeshova
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. B. Fantino
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Olivier Beauchet
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Olivier Beauchet.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Launay, C., De Decker, L., Annweiler, C. et al. Association of depressive symptoms with recurrent falls: A cross-sectional elderly population based study and a systematic review. J Nutr Health Aging 17, 152–157 (2013). https://doi.org/10.1007/s12603-012-0370-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12603-012-0370-z

Key words

Search

Navigation