Journal of Primary Health Care Journal of Primary Health Care Society
Journal of The Royal New Zealand College of General Practitioners
RESEARCH ARTICLE (Open Access)

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 1
+ Author Affiliations
- Author Affiliations

1 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 - https://doi.org/10.1071/HC17012
Published online: 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 | 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 |

[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 |

[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 |

[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 |

[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 |

[10]  Hausdorff JM. Stride variability: beyond length and frequency. Gait Posture. 2004; 20 304–10.
Stride variability: beyond length and frequency.CrossRef | 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 | 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 |

[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 |

[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 | 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 |


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