Falls, depression and antidepressants in later life: a large primary care appraisal. Export

@article{citeulike:4155337, abstract = {BACKGROUND: Depression and falls are common and co-exist for older people. Safe management of each of these conditions is important to quality of life. METHODS: A cross-sectional survey was used to examine medication use associated with injurious and non-injurious falls in 21,900 community-dwelling adults, aged 60 years or over from 383 Australian general practices recruited for the DEPS-GP Project. Falls and injury from falls, medication use, depressive symptoms (Primary Health Questionnaire (PHQ-9)), clinical morbidity, suicidal ideation and intent, health status (SF-12 Health Survey), demographic and lifestyle information was reported in a standardised survey. FINDINGS: Respondents were 71.8 years (sd 7.7) of age and 58.4\% were women. 24\% 11\% and 8\% reported falls, fall related injury, and sought medical attention respectively. Antidepressant use (odds ratio, OR: 1.46; 95\% confidence interval, 95\%CI: 1.25, 1.70), questionable depression (5-14 on PHQ OR: 1.32, 95\%CI: 1.13, 1.53) and clinically significant symptoms of depression (15 or more on PHQ OR: 1.70, 95\%CI: 1.14, 1.50) were independently associated with multiple falls. SSRI use was associated with the highest risk of multiple falls (OR: 1.66, 95\%CI: 1.36, 2.02) amongst all psychotropic medications. Similar associations were observed for injurious falls. Over 60\% of those with four accumulated risk factors had multiple falls in the previous year (OR: 3.40, 95\%CI: 1.79, 6.45); adjusted for other demographic and health factors. INTERPRETATION: Antidepressant use (particularly SSRIs) was strongly associated with falls regardless of presence of depressive symptoms. Strategies to prevent falls should become a routine part of the management of older people with depression.}, author = {Kerse, N. and Flicker, L. and Pfaff, J. J. and Draper, B. and Lautenschlager, N. T. and Sim, M. and Snowdon, J. and Almeida, O. P.}, citeulike-article-id = {4155337}, citeulike-linkout-0 = {http://dx.doi.org/10.1371/journal.pone.0002423}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/18560599}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=18560599}, doi = {10.1371/journal.pone.0002423}, issn = {1932-6203}, journal = {PLoS ONE}, keywords = {antidepressiva, depressie, geriatrie, vallen}, number = {6}, posted-at = {2009-03-09 14:42:13}, priority = {2}, title = {Falls, depression and antidepressants in later life: a large primary care appraisal.}, url = {http://dx.doi.org/10.1371/journal.pone.0002423}, volume = {3}, year = {2008} }

TY - JOUR ID - citeulike:4155337 L3 - citeulike-article-id:4155337 N2 - BACKGROUND: Depression and falls are common and co-exist for older people. Safe management of each of these conditions is important to quality of life. METHODS: A cross-sectional survey was used to examine medication use associated with injurious and non-injurious falls in 21,900 community-dwelling adults, aged 60 years or over from 383 Australian general practices recruited for the DEPS-GP Project. Falls and injury from falls, medication use, depressive symptoms (Primary Health Questionnaire (PHQ-9)), clinical morbidity, suicidal ideation and intent, health status (SF-12 Health Survey), demographic and lifestyle information was reported in a standardised survey. FINDINGS: Respondents were 71.8 years (sd 7.7) of age and 58.4% were women. 24% 11% and 8% reported falls, fall related injury, and sought medical attention respectively. Antidepressant use (odds ratio, OR: 1.46; 95% confidence interval, 95%CI: 1.25, 1.70), questionable depression (5-14 on PHQ OR: 1.32, 95%CI: 1.13, 1.53) and clinically significant symptoms of depression (15 or more on PHQ OR: 1.70, 95%CI: 1.14, 1.50) were independently associated with multiple falls. SSRI use was associated with the highest risk of multiple falls (OR: 1.66, 95%CI: 1.36, 2.02) amongst all psychotropic medications. Similar associations were observed for injurious falls. Over 60% of those with four accumulated risk factors had multiple falls in the previous year (OR: 3.40, 95%CI: 1.79, 6.45); adjusted for other demographic and health factors. INTERPRETATION: Antidepressant use (particularly SSRIs) was strongly associated with falls regardless of presence of depressive symptoms. Strategies to prevent falls should become a routine part of the management of older people with depression. IS - 6 JF - PLoS ONE SN - 1932-6203 TI - Falls, depression and antidepressants in later life: a large primary care appraisal. VL - 3 KW - antidepressiva KW - depressie KW - geriatrie KW - vallen AU - Kerse, N AU - Flicker, L AU - Pfaff, JJ AU - Draper, B AU - Lautenschlager, NT AU - Sim, M AU - Snowdon, J AU - Almeida, OP PY - 2008/// UR - http://dx.doi.org/10.1371/journal.pone.0002423 ER -