Falls and depression in octogenarians - life and living in advanced age: a cohort study in New Zealand
Astrid Atlas 1 , Ngaire Kerse 2 , Anna Rolleston 3 , Ruth Teh 1 , Catherine Bacon 11 University of Auckland, School of Population Health, General Practice and Primary Health Care, Auckland, New Zealand
2 Auckland University of Technology, School of Population Health, Auckland, New Zealand
3 Faculty of Medicine and Health Science, University of Auckland, New Zealand
Correspondence to: Dr Astrid Atlas, Honorary Research Fellow, School of Population Health, General Practice and Primary Health Care, University of Auckland, Auckland 1142, New Zealand. Email: astridatlas@yahoo.com
Journal of Primary Health Care 9(4) 311-315 https://doi.org/10.1071/HC17012
Published: 25 August 2017
Journal Compilation © Royal New Zealand College of General Practitioners 2017.
This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Abstract
INTRODUCTION: Falls and injury have the most devastating consequences for very old people. Depression may be a significant cause and consequence of falls.
AIM: To examine the association between falls and depression in octogenarians.
METHODS: LiLACS NZ (Life and Living in Advanced Age: A Cohort Study in New Zealand), cohort study data of Māori (aged 80–90 years, 11-year age band) and non-Māori (aged 85 years, 1-year age band) followed for 3 years was used to describe the incidence and prevalence of falls and depression. Falls by self-report were accumulated over 3 years. Geriatric depression score (GDS) was ascertained at baseline.
RESULTS: Over 3 years, fewer Māori (47%) than non-Māori (57%) fell; 19% of non-Māori and 20% of Māori scored 5+ (depressed) on the GDS. For non-Māori and Māori, people with depression were more likely to fall than Māori not diagnosed with depression (OR 2.72, CI 1.65–4.48 for non-Māori and OR 2.01, CI 1.25–3.25 for Māori). This remained significant, adjusted for age and sex. Depression was a significant predictor of hospitalisations from falls for Māori (OR 5.59, CI 2.4–12.72, adjusted for age and sex) and non-Māori (OR 4.21, 2.3–7.44, adjusted for sex).
CONCLUSION: Depression and falls are common and co-exist in octogenarians. GPs thinking about falls should also think about depression and vice versa.
KEYWORDS: Octogenarians; falls; depression; LiLACs NZ
References
[1] National Populations Projection. 2009(base)–2061. National populations projection - Stats NZ Tatauranga Aotearoa. [cited 2016 September 15]. Available from: www.stats.govt.nz/browse_for_stats/population/estimates_and_projections/nationalpopulationprojections_hotp09base-61.aspx[2] New South Wales Health. The epidemiology of falls in older people in NSW; 1994. www.healthstats.nsw.gov.au
[3] Accident Compensation Corporation. Injury Statistics Tool. [cited 2015 June 30]. Available from http://www.acc.co.nz/about-acc/statistics/injury-statistics/index.htm#results
[4] Heinrich S, Rapp K, Rissmann U, et al. Cost of falls in old age: a systematic review. Osteoporos Int. 2010; 21 891–902.
| Cost of falls in old age: a systematic review.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC3c3pslygsA%3D%3D&md5=f0ed0179fe6553d881601bc8adc4faf6CAS |
[5] Stel VS, Smit JH, Pluijm SMF, Lips P. Consequences of falling in older men and women and risk factors for health service use and functional decline Age Ageing. 2004; 33 58–65.
| Consequences of falling in older men and women and risk factors for health service use and functional declineCrossref | GoogleScholarGoogle Scholar |
[6] Hybels CF, Blazer DG. Epidemiology of late-life mental disorders. Clin Geriatr Med. 2003; 19 663–96.
| Epidemiology of late-life mental disorders.Crossref | GoogleScholarGoogle Scholar |
[7] Kerse N, Teh R, Moyes S, et al. Cohort Profile: Te Puawaitanga o Nga Tapuwae Kia Ora Tonu, Life and living in advanced age: a cohort study in New Zealand (LiLACS NZ). Int J Epidemiol. 2015; 44 1823–32.
| Cohort Profile: Te Puawaitanga o Nga Tapuwae Kia Ora Tonu, Life and living in advanced age: a cohort study in New Zealand (LiLACS NZ).Crossref | GoogleScholarGoogle Scholar |
[8] Yeasavage JA, Sheikh JI. Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. Clin Gerontol. 1986; 5 165–73.
| Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version.Crossref | GoogleScholarGoogle Scholar |
[9] Sloman L, Berridge M, Homatidis S, et al. Gait patterns of depressed patients and normal subjects. Am J Psychiatry. 1982; 13 94–7.
| Gait patterns of depressed patients and normal subjects.Crossref | GoogleScholarGoogle Scholar |
[10] Hausdorff JM. Stride variability: beyond length and frequency. Gait Posture. 2004; 20 304–10.
| Stride variability: beyond length and frequency.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2crlvVylsw%3D%3D&md5=f4b869cd1ea1dccfe93de2c41bcfb148CAS |
[11] Masdeu JC, Wolfson L, Lantos G, et al. Brain white matter changes in elderly prone to falling. Arch Neurol. 1989; 46 1292–6.
| Brain white matter changes in elderly prone to falling.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK3c%2FntlarsQ%3D%3D&md5=72ac608c9ca364e5507cfd62996dc948CAS |
[12] Arroll B, Goodyear-Smith F, Lloyd T. Depression in patients in an Auckland general practice. N Z Med J. 2002; 115 176–9.
[13] Arroll B, Khin N, Kerse N. Screening for depression in primary care with two verbally asked questions: cross sectional study. BMJ. 2003; 327 1144–6.
| Screening for depression in primary care with two verbally asked questions: cross sectional study.Crossref | GoogleScholarGoogle Scholar |
[14] Sherrington C, Tiedemann A, Fairhall NJ, et al. Exercise for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2016; CD012424
| Exercise for preventing falls in older people living in the community.Crossref | GoogleScholarGoogle Scholar |
[15] Carter SE, Campbell EM, Sanson-Fisher RW, et al. Environment hazards in the homes of older people. Age Ageing. 1997; 26 195–202.
| Environment hazards in the homes of older people.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2szms12jsA%3D%3D&md5=60274b5292b64d859904f88ff42de09fCAS |
[16] Coupland C, Dhiman P, Morriss R, Arthur AG. Antidepressant use and risk of adverse outcomes in older people: population based cohort study. BMJ. 2011; 343 d4551.
[17] Kerse N, Flicker L, Pfaff JJ, et al. Falls, depression and antidepressants in later life: a large primary care appraisal. PLoS One. 2008; 3 e2423
| Falls, depression and antidepressants in later life: a large primary care appraisal.Crossref | GoogleScholarGoogle Scholar |
