Depression and falls among community dwelling elderly people: a search for common risk factors
Open accessAbstract
Study objectives: Depression and falls are two common conditions that impair the health of older people. Both are relatively underdiagnosed and undertreated problems in primary care. The study objective was to investigate whether there was a common set of risk factors that could predict an increased risk of both falls and depression. Design: This was a cohort study drawn from a primary care clinic, with a one year follow up. Dependent measures included: reporting two or more falls in the past year and a score of 7 or over on the S-GDS (Short Geriatric Depression Scale). A parsimonious set of risk factors was selected that predicted both outcomes based on a series of discriminant function analyses. Participants and setting: The setting was a primary care clinic serving a mixed socioeconomic population, in Beer Sheva, Israel. The sample included 283 General Sick Fund members, aged 60 and over, who completed both baseline assessments and one year follow up interviews. Main results: At the one year follow up, 12% of the sample reported frequent falls in the past year and 25.5% of the sample screened positive for depressive symptoms. A set of five risk factors that included: poor self rated health, poor cognitive status, impaired ADL, two or more clinic visits in the past month, and slow walking speed (g10 seconds over five metres) was successful at discriminating between fallers and non-fallers (86% discrimination) and between those with and without depressive symptoms (76%). For every risk factor added, there was a significant increase in the proportion of respondents who had depressive symptoms. A similar result was found for falls. Conclusions: These results show that there is a common set of risk factors that increase the risk of two common outcomes in geriatric medicine, falls and depression. For a general practitioner or a geriatric physician, it might be easier to detect these risk factors than to diagnose depression or high risk for falls. When these risk factors are detected in patients the physician can then be more active in direct probing about depression and falls.
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Other cohorts with similar follow-ups and populations have shown results in line with the EPIDOS cohort.
“Other cohorts with similar follow-ups and population have shown results in the line with the EPIDOS cohort ( 43., 44., 45.).”
In General Sick Fund Members, slow gait speed (<0.5 ms-1) was an independent predictor of falls with a relative risk of 1.41 (1.16-1.73).
“Slow gait speed (<0.5 ms-1) was an independent predictor of falls with a RR of 1.41 (1.16-1.73)”
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- Authors
- Biderman, A., Cwikel, J., Fried, A. V., & Galinsky, D.
- Affiliations
- Ben-Gurion University of the Negev (IL)
- Corresponding author
- Biderman, A
- ORCID
- Venue
- Journal of Epidemiology and Community Health
- Publisher
- BMJ
- Published
- 2002-08
- Volume
- 56
- Issue
- 8
- Pages
- 631-636
- ISSN
- 0141-7681 (ISSN-L)
- 0143-005X
- 1470-2738
- PMC
- PMC1732215
- OpenAlex
- W2145656642
- Cited by
- 229
- References
- 27
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 1 · 2023: 4 · 2022: 9 · 2021: 17 · 2020: 14 · 2019: 12 · 2018: 10 · 2017: 16 · 2016: 13 · 2015: 18 · 2014: 17 · 2013: 15 · 2012: 9
- FWCI
- 18.24
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Epidemiology & Community Health (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Keywords
- depression, falls, older adults, risk factors, geriatric depression, self-rated health, cognitive impairment, activities of daily living, walking speed, primary care, fall risk prediction
- MeSH terms
- Accidental Falls, Activities of Daily Living, Aged, Aged, 80 and over, Depressive Disorder, Female, Follow-Up Studies, Health Status Indicators, Humans, Israel, Male, Middle Aged, Primary Health Care, Risk Factors, Geriatric Assessment, Risk Assessment
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