Korean J Fam Pract. 2018; 8(5): 696-702  https://doi.org/10.21215/kjfp.2018.8.5.696
The Association between Depression and Falls in Korean Adults Aged 45 Years or Older
Su Gyeong Kim1, Sujin Kim2, Kyae Hyung Kim1, Su-min Jeong1, Ahryoung Ko1, Sil Vi Han1, Sang Min Park1,3,*
1Department of Family Medicine, Seoul National University Hospital, Seoul, Korea; 2Takemi Program in International Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA; 3Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea
Sang Min Park
Tel: +82-2-2072-3331, Fax: +82-2-766-3276
E-mail: smpark.snuh@gmail.com
ORCID: http://orcid.org/0000-0002-7498-4829
Received: July 11, 2017; Revised: September 26, 2017; Accepted: October 11, 2017; Published online: October 20, 2018.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Falls are common in older adults and are associated with increased morbidity and mortality. Depression is also a common health issue observed in this population; however, its effect is underestimated, particularly in a growing population of older adults. This cross-sectional study investigated the association between depression and falls in Korean adults.
Methods: We utilized the Korean Longitudinal Study of Ageing database. We enrolled 10,180 subjects, aged ≥45 years in 2006 after excluding those with missing data. Depression was assessed using the 10-item Center for Epidemiologic Studies Depression Scale tool, and falls were assessed using patient self-reports. Multiple logistic regression analysis was used to evaluate the association between depression and falls after adjusting for sex, age, marital status, education, income, location, smoking status, alcohol consumption, physical activity, activities of daily living, cognitive function, and handgrip strength and vision.
Results: Of the 10,180 subjects studied, 410 reported falls. The adjusted odds ratio for all falls in the depressive group (compared to the non-depressive group) was 1.70 (95% confidence interval [CI] 1.31–2.21). The adjusted odds ratios for falls needing treatment and those causing hip fractures were 1.63 (95% CI 1.20–2.24) and 2.10 (95% CI 1.35–3.26), respectively.
Conclusion: Depression was associated with an increased risk of all falls, as well as falls needing treatment and those causing hip fractures.
Keywords: Depression; Falls; Fracture; Korean Longitudinal Study of Aging
References
  1. Ageing WHO, Ageing and Life Course Unit. WHO global report on falls prevention in older age. Geneva: World Health Organization; 2008.
  2. Blake AJ, Morgan K, Bendall MJ, Dallosso H, Ebrahim SB, Arie TH, et al. Falls by elderly people at home: prevalence and associated factors. Age Ageing 1988; 17: 365-72.
    Pubmed CrossRef
  3. 2011 Survey of the elderly [internet]. Sejong: Ministry of Health & Welfare;2012. [cited 2017 Jun 28].
    Available from: http://www.kihasa.re.kr/common/filedown.do?seq=16377
  4. Stevens JA, Hasbrouck LM, Durant TM, Dellinger AM, Batabyal PK, Crosby AE, et al. Surveillance for injuries and violence among older adults. MMWR Surveill Summ 1999; 48: 27-50.
  5. Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing 2006; 35 Suppl 2: ii37-41.
    Pubmed CrossRef
  6. Letts L, Moreland J, Richardson J, Coman L, Edwards M, Ginis KM, et al. The physical environment as a fall risk factor in older adults: systematic review and meta-analysis of cross-sectional and cohort studies. Aust Occup Ther J 2010; 57: 51-64.
    Pubmed CrossRef
  7. Schulz R, Beach SR, Ives DG, Martire LM, Ariyo AA, Kop WJ. Association between depression and mortality in older adults: the Cardiovascular Health Study. Arch Intern Med 2000; 160: 1761-8.
    Pubmed CrossRef
  8. Blazer DG. Depression in late life: review and commentary. J Gerontol A Biol Sci Med Sci 2003; 58: 249-65.
    Pubmed CrossRef
  9. Pérez-Stable EJ, Miranda J, Muñoz RF, Ying YW. Depression in medical outpatients. Underrecognition and misdiagnosis. Arch Intern Med 1990; 150:1083-8.
    Pubmed CrossRef
  10. Biderman A, Cwikel J, Fried AV, Galinsky D. Depression and falls among community dwelling elderly people: a search for common risk factors. J Epidemiol Community Health 2002; 56: 631-6.
    Pubmed KoreaMed CrossRef
  11. 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: 484-90.
    Pubmed CrossRef
  12. Kvelde T, McVeigh C, Toson B, Greenaway M, Lord SR, Delbaere K, et al. Depressive symptomatology as a risk factor for falls in older people: systematic review and meta-analysis. J Am Geriatr Soc 2013; 61: 694-706.
    Pubmed CrossRef
  13. Lim JY, Park WB, Oh MK, Kang EK, Paik NJ. Falls in a proportional region population in Korean elderly: incidence, consequences, and risk factors. Ann Geriatr Med Res 2010; 14: 8-17.
    CrossRef
  14. Hong GR, Cho SH, Tak Y. Falls among Koreans 45 years of age and older:incidence and risk factors. J Adv Nurs 2010; 66: 2014-24.
    Pubmed
  15. Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1977; 1: 385-401.
    CrossRef
  16. Andresen EM, Malmgren JA, Carter WB, Patrick DL. Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prev Med 1994; 10: 7784.
    CrossRef
  17. Law MR, Hackshaw AK. A meta-analysis of cigarette smoking, bone mineral density and risk of hip fracture: recognition of a major effect. BMJ 1997;315: 841-6.
    CrossRef
  18. Rock PL, Roiser JP, Riedel WJ, Blackwell AD. Cognitive impairment in depression:a systematic review and meta-analysis. Psychol Med 2014; 44:2029-40.
    Pubmed CrossRef
  19. Turcu A, Toubin S, Mourey F, D’Athis P, Manckoundia P, Pfitzenmeyer P. Falls and depression in older people. Gerontology 2004; 50: 303-8.
    Pubmed CrossRef
  20. Leipzig RM, Cumming RG, Tinetti ME. Drugs and falls in older people: a systematic review and meta-analysis: I. Psychotropic drugs. J Am Geriatr Soc 1999; 47: 30-9.
    Pubmed CrossRef
  21. Marcum ZA, Perera S, Thorpe JM, Switzer GE, Castle NG, Strotmeyer ES, et al. Antidepressant use and recurrent falls in community-dwelling older adults: findings from the Health ABC Study. Ann Pharmacother 2016; 50:525-33.
    Pubmed KoreaMed CrossRef
  22. Rosendahl E, Lundin-Olsson L, Kallin K, Jensen J, Gustafson Y, Nyberg L. Prediction of falls among older people in residential care facilities by the Downton index. Aging Clin Exp Res 2003; 15: 142-7.
    Pubmed CrossRef
  23. Granek E, Baker SP, Abbey H, Robinson E, Myers AH, Samkoff JS, et al. Medications and diagnoses in relation to falls in a long-term care facility. J Am Geriatr Soc 1987; 35: 503-11.
    Pubmed CrossRef
  24. McNeil JK, LeBlanc EM, Joyner M. The effect of exercise on depressive symptoms in the moderately depressed elderly. Psychol Aging 1991; 6: 487-8.
    Pubmed CrossRef
  25. Blumenthal JA, Babyak MA, Moore KA, Craighead WE, Herman S, Khatri P, et al. Effects of exercise training on older patients with major depression. Arch Intern Med 1999; 159: 2349-56.
    Pubmed CrossRef
  26. Sherrington C, Whitney JC, Lord SR, Herbert RD, Cumming RG, Close JC. Effective exercise for the prevention of falls: a systematic review and metaanalysis. J Am Geriatr Soc 2008; 56: 2234-43.
    Pubmed CrossRef

This Article


Author ORCID Information

Services
Social Network Service

e-submission

Archives